Revenue Cycle Analyst | Remote

Key Responsibilities

• Identify and recover underpayments and payment variances across payer contracts, applying working knowledge of DRG-based, per diem, percent-of-billed charges, and fee schedule reimbursement methodologies
• Interpret complex payer contract terms — including fee schedules, carve-outs, outlier provisions, and bundled payment structures — to validate claim payments and flag systematic discrepancies
• Conduct contract modelling and payment reconciliation to uncover patterns of underpayment across payer classes; develop and submit recovery correspondence accordingly
• Evaluate model-generated underpayment alerts, contract compliance outputs, and payment variance analyses for clinical and financial accuracy, providing structured annotation and feedback
• Monitor recovery performance metrics including identified underpayment volume, recovery rates, and payer dispute response timelines
• Identify contract language gaps and escalate renegotiation opportunities to managed care contracting leadership

Core Requirements

• Demonstrated expertise in underpayment recovery, payment variance analysis, or managed care contracting with a track record in complex multi-payer environments
• Deep command of payer payment methodologies across DRG, per diem, percent-of-billed charges, and fee schedule structures
• Proven ability to conduct contract modelling, payer dispute resolution, and reconciliation at scale
• Proficiency in Excel-based financial analysis and familiarity with revenue cycle analytics platforms or contract management systems
• Working knowledge of HIPAA compliance requirements and timely filing standards applicable to underpayment recovery
• Exceptional written communication skills; ability to produce precise recovery correspondence and structured analytical documentation

Additional Strengths

• CHFP, CRCR, or managed care contracting certification (Experian Health, Recondo, or equivalent platform experience a plus)
• Background in hospital, health system, or large physician group underpayment operations with exposure to executive-level underpayment reporting
• Comfort evaluating and annotating automation-generated outputs within a structured feedback workflow