Revenue Cycle Analyst - Denials & Appeals in New York at Jobgether
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Job Description
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Revenue Cycle Analyst - Denials & Appeals based in United States.
This role supports revenue cycle operations by turning complex denials and appeals data into actionable business insights.
You’ll serve as a key analytical resource for post-appeal payer response tracking and resolution workflows.
The position combines data analysis, operational reporting, workflow improvement, and healthcare revenue cycle expertise.
You’ll monitor backlog trends, SLA performance, appeal response rates, and resolution patterns across payer types.
Working with operational leaders and cross-functional teams, you’ll identify root causes and recommend practical improvements.
The role offers an opportunity to influence technology, processes, and performance across both onshore and offshore teams.
It is ideal for an analytical, detail-oriented professional who can translate large datasets into clear operational decisions.
- Serve as the primary analytical resource for post-appeal and unresponded payer activity across commercial and non-commercial plans, providing accurate and timely reporting.
- Monitor key performance indicators including backlog aging, SLA adherence, appeal response rates, resolution trends, and team productivity.
- Lead or support recurring performance reviews by presenting trends, identifying workflow gaps, and highlighting opportunities for operational improvement.
- Analyze large datasets to identify root causes of backlog growth, payer-specific delays, errors, and other patterns affecting denials and appeals performance.
- Partner with operational leadership to translate analytical findings into actionable workflow recommendations and technology or systems improvement requirements.
- Support the configuration and validation of billing systems and payer portal workflows to improve the accuracy and timeliness of appeal-response tracking.
- Collaborate with Denials & Appeals teams to quantify error trends and incorporate findings into ongoing feedback and improvement processes.
- Track onshore and offshore team performance and provide productivity reporting to supervisors and leadership.
- Research payer-specific appeal requirements, billing and coding updates, and reimbursement policy changes, translating relevant developments into recommended departmental actions.
- Develop and maintain project plans for workflow enhancements, backlog reduction initiatives, and SLA improvement programs while managing multiple priorities.
- 4–6 years of experience in medical billing, denials management, insurance collections, revenue cycle operations, or a closely related healthcare environment.
- Bachelor’s degree in Business, Healthcare Administration, or a related field is preferred.
- Experience working with or analyzing post-appeal payer response workflows, with a strong understanding of the appeals lifecycle from submission through resolution.
- Familiarity with commercial and non-commercial payer plans, appeal processes, and multiple payer portals is required; experience with AMD is preferred.
- Advanced knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes.
- Advanced Microsoft Excel and data analysis capabilities, including the ability to work with large datasets, identify trends, and validate data accuracy.
- Basic SQL experience, Power BI knowledge, and experience working with raw data are highly preferred.
- Strong ability to convert data and analytical findings into practical recommendations for operational and leadership audiences.
- Excellent communication and presentation skills, with the ability to collaborate effectively across offshore and onshore teams as well as technology and other cross-functional stakeholders.
- Strong project management, organization, prioritization, and problem-solving skills in a high-volume, SLA-driven environment.
- Exceptional attention to detail and accuracy, particularly when working with sensitive healthcare and payer information.
- Ability to maintain confidentiality when accessing protected health information (PHI).
- Salary: $65,400–$95,200 USD annually for remote U.S. employees.
- Compensation flexibility: Actual compensation is determined based on skills, qualifications, experience, certifications, and location.
- Healthcare coverage: Comprehensive medical, dental, vision, life, and disability insurance for eligible employees and dependents.
- Family and fertility support: Fertility care benefits, pregnancy leave, and baby-bonding leave.
- Retirement: 401(k) benefits.
- Additional perks: Commuter benefits and an employee referral program.
- Employee wellness: Resources and programs designed to support overall wellbeing.
- Work arrangement: Remote position within the United States.