Sr. Reimbursement Analyst-Denials/Appeals

Labcorp•Burlington, NC

5d•Hybrid

About The Position

Labcorp is seeking a HYBRID Senior Reimbursement Analyst (III) to join our team! This hybrid position offers a balanced schedule of three in-office workdays at our Burlington or Durham, NC locations and two remote workdays per week, supporting both collaboration and flexibility. The Senior Reimbursement Analyst is responsible for leading the identification, prioritization, and strategic development of appeal opportunities through advanced analytics and payer policy expertise. This role focuses on designing scalable appeal strategies, identifying systemic denial issues, and guiding appeal positioning to maximize reimbursement and reduce revenue leakage. This position leverages large healthcare datasets, advanced analytics, and emerging technologies to identify high-value recovery opportunities and improve efficiency in reimbursement strategy execution. The role partners closely with Revenue Cycle Operations, Payor Solutions, and Reimbursement leadership to implement scalable solutions and address root causes of denials.

Requirements

Bachelor’s degree with 7+ years of experience in healthcare revenue cycle, reimbursement, or denial management OR Associate degree with 9 years of experience in healthcare revenue cycle, reimbursement, or denial management OR HS diploma or GED with 11 years of experience in healthcare revenue cycle, reimbursement, or denial management
Advanced Microsoft Excel (required)

Nice To Haves

7+ years of experience in healthcare revenue cycle, reimbursement, or denial management
5+ years of hands-on experience analyzing healthcare datasets, including claims, denials, and remittance data, with demonstrated ability to identify trends and actionable insight
Advanced proficiency in Microsoft Excel, including large dataset manipulation and data analysis
Direct experience managing appeals and denials across commercial and/or government payers, including tracking outcomes and driving resolution strategies
Demonstrated experience drafting appeal letters with supporting clinical and policy rationale
Strong knowledge of medical terminology and healthcare billing/coding concepts
Proven ability to interpret payer policy language and translate policy criteria into actionable appeal strategies or reimbursement opportunities
Experience with laboratory billing, diagnostics, or molecular/genetic testing
Clinical or coding credentials (e.g., RN, LPN, MT/MLS, CPC, CCS)
Experience with policy research or reimbursement optimization
SQL or similar data query tools (preferred)
Data visualization tools (Tableau, Power BI) (preferred)
Analytical tools (SAS) (preferred)

Responsibilities

Identify and prioritize high-value, scalable appeal opportunities across commercial and government payers
Develop and standardize appeal strategies and frameworks based on payer policy, denial trends, and financial impact
Draft complex or exemplar appeals to establish best practices and reusable templates
Partner with operational teams to enable execution of appeals at scale, rather than performing routine claim-level submissions
Analyze large healthcare datasets (claims, remittance, denial, and clinical data) to identify trends, root causes, and recovery opportunities
Design and execute advanced data mining techniques to surface actionable insights and quantify financial impact
Translate data insights into enterprise-level appeal strategies and recovery initiatives, not individual claim resolution
Interpret payer policies, LCD/NCDs, and medical necessity criteria to assess appeal viability
Apply knowledge of billing guidelines, coding (CPT/HCPCS), and reimbursement methodologies
Identify policy misalignment and develop targeted appeal strategies or escalation approaches
Partner with Revenue Cycle, Denial Operations, and Payor Solutions teams to address systemic denial issues
Provide subject matter expertise and guidance on appeal strategy and policy interpretation
Support process improvement initiatives aimed at reducing denials and optimizing reimbursement