Senior Reimbursement Analyst (REMOTE)

Labcorp•Burlington, NC

1d•Remote

About The Position

The Sr. Reimbursement Analyst is responsible for providing advanced analytical support related to third-party denials, reimbursement issues, and appeals initiatives. This role conducts detailed data analyses, identifies billing and payor trends, and collaborates with Revenue Cycle Operations and the lead Reimbursement Administrator to implement process improvements that maximize revenue and ensure compliance with payor and regulatory guidelines.

Requirements

Bachelor’s Degree or equivalent work experience.
6+ years of experience analyzing and manipulating large data sets in a healthcare revenue cycle setting.
Advanced proficiency in Microsoft Excel.
Strong knowledge of payor contracts, medical terminology, commercial and government health insurance, billing guidelines, and appeals processes.
Proven analytical and critical thinking skills.
Excellent communication and presentation skills.
Ability to work independently and collaboratively in a fast-paced environment.

Nice To Haves

Experience with data tools such as SAS, Crystal Reports, Business Objects, or similar platforms preferred.

Responsibilities

Analyze third-party denial trends and reimbursement issues to identify root causes and recommend corrective actions.
Lead and support appeals initiatives, collaborating with Reimbursement Administrator, including identifying appeal opportunities, tracking outcomes, and collaborating with internal and external teams to improve success rates.
Conduct detailed analyses of data related to existing or proposed revenue cycle projects, including payor performance and denial resolution.
Develop and present findings through graphs, charts, written summaries, and presentations for leadership review.
Collaborate with Revenue Cycle Operations to identify areas for improvement and support the implementation of strategic projects.
Assist in the development and documentation of Standard Operating Procedures (SOPs) for denial management and appeals processes.
Manage the implementation of process improvements across the revenue cycle, ensuring alignment with organizational goals.
Provide timely and accurate updates to management on outstanding denial and appeal trends using defined systems and tracking mechanisms.
Ensure timely follow-up on unresolved issues to minimize business risks and revenue loss.
Stay current with payor guidelines, regulatory changes, and industry best practices related to reimbursement and appeals.
Perform other duties as assigned.