RCM Analyst

About the role

The RCM Analyst will play a crucial role in the revenue cycle team, focusing on identifying and resolving denials to improve recovery rates and operational efficiency.

Responsibilities

• Analyze denial patterns across payers, HCPCS codes, and product lines to identify systemic root causes.
• Conduct direct payer outreach, calling insurance representatives, and escalating cases to discover the root cause of denials and underpaid claims.
• Build and maintain denial, issue, and project tracking dashboards and reporting packages.
• Develop methodologies for denial prioritization and perform root cause analysis on high-volume and high-dollar denials.
• Partner with coders, billers, and front-end staff to reduce revenue leakage through upstream gaps contributing to recurring denials.
• Maintain awareness of payer policy changes and updates, flagging impacts to current billing practices and advising on workflow adjustments.
• Collaborate with product and engineering teams to provide insights into the root cause of denials and assist in crafting solutions.

Requirements

• Experience in RCM with at least 1–2 years in a consulting or advisory capacity.
• Demonstrated experience working denials across commercial, Medicare, and Medicaid payers.
• Proven ability to call payers directly, navigate payer portals, and manage the appeals lifecycle.
• Proficiency in Excel / Google Sheets for data manipulation and pivot analysis.
• Familiarity with payer portals such as Availity.
• Familiarity with SQL.
• Experience with reporting tools or BI platforms.
• Working knowledge of CPT, ICD-10, and HCPCS coding conventions.

Qualifications

• Exceptional attention to detail.
• You catch what others miss.

Skills

• Technical skills including proficiency in Excel / Google Sheets, familiarity with payer portals, and SQL.

Benefits

Verse Medical offers competitive benefits, professional development opportunities, and a culture that prioritizes work-life balance and continuous improvement.

Pay

Competitive compensation package based on experience and qualifications.

Schedule

Full-time position with flexible hours to accommodate the needs of the revenue cycle team.

Verse Medical Pledge for an Equitable Future

We are committed to building a workplace where everyone feels a sense of belonging, where their contributions are valued, and where they can do their best work. We embrace diversity of all kinds: race, gender, age, religion, identity, experience. We are actively working to build a more inclusive and equitable world, starting from within our own walls.