Revenue Cycle Analyst - Denials & Appeals

About Our Client

The organization operates in the healthcare diagnostics industry, focusing on cell-free DNA testing across oncology, women’s health, and organ health. It addresses the challenge of integrating personalized genetic testing and advanced diagnostics into standard care to enable earlier, more targeted interventions and improve health outcomes.

About the Opportunity

The Revenue Cycle Analyst - Denials & Appeals supports billing operations by analyzing post-appeal payer responses, monitoring workflow performance, and identifying opportunities to improve denials and appeals processes. This role provides analytical insights that connect team performance with departmental goals while helping management address backlogs, payer delays, and operational inefficiencies.

Responsibilities

• Serve as the primary analytical resource for tracking and reporting post-appeal payer response activity.
• Monitor key performance metrics including backlog aging, SLA adherence, productivity, and resolution trends.
• Lead or support weekly metric reviews and present findings to stakeholders.
• Analyze unresponded appeal data to identify root causes of backlogs and payer delays.
• Partner with management to recommend workflow, process, and system improvements.
• Support billing systems and payer portal validation to ensure accurate appeal tracking.
• Collaborate with Denials & Appeals teams to document error trends and incorporate findings into operational improvements.
• Track team productivity and support performance reporting across onshore and offshore teams.
• Research payer-specific requirements and policy changes to inform departmental actions.
• Develop and maintain project plans for workflow improvement and backlog reduction initiatives.
• Perform other duties as assigned.

Requirements

• Bachelor's degree in Business, Healthcare Administration, or a related field preferred.
• 4–6 years of experience in medical billing, denials management, insurance collections, or revenue cycle operations.
• Experience analyzing post-appeal payer response workflows.
• Advanced Excel and data analysis skills.
• Basic SQL knowledge and experience with Power BI and raw datasets preferred.
• Familiarity with commercial and non-commercial payer plans and appeal processes.
• Advanced knowledge of CPT/HCPCS, ICD-10, modifiers, and UB revenue codes.
• Experience working with multiple payer portals; AMD experience preferred.
• Strong analytical, project management, and communication skills.
• Ability to maintain confidentiality of protected health information.
• Strong attention to detail and ability to identify trends, discrepancies, and process improvement opportunities.

Pay

Annual salary range: USD $65,400–$95,200. Compensation is based on experience, skills, certifications, location, and other relevant factors.