Revenue Analyst II - Denials & Underpayment Resolution

 About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. 

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.  

JOB SUMMARY:

The Revenue Analyst II is responsible for identifying, researching, and resolving payer underpayments, denials, and unpaid claims to maximize client reimbursement and revenue recovery. This role combines advanced revenue cycle analysis with direct claims resolution activities, including payer follow-up, contract review, account research, and appeals management. The Revenue Analyst II serves as a subject matter expert, mentors team members, and collaborates with internal stakeholders to identify trends and improve financial outcomes for clients.
This is a remote role.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

This is a remote role.

Key Responsibilities

Revenue Analysis & Underpayment Recovery

• Independently assess business priorities and adjust workflow to review accounts for potential payer underpayments and reimbursement opportunities.
• Analyze information from multiple sources, including hospital systems, medical records, claims data, EOBs, payer portals, and client systems, to determine root causes of underpayments and denials.
• Research payer and client trends to identify revenue risks and maximize reimbursement opportunities.
• Evaluate account profitability and cost-benefit considerations when determining appropriate follow-up actions, rebills, or appeals.
• Review payer contracts and reimbursement methodologies to identify revenue leakage and reimbursement risks.

Claims Resolution & Insurance Follow-Up

• Resolve unpaid, denied, and underpaid claims through outbound calls, appeals, correspondence, payer portal research, and client system review.
• Review medical documentation, including UB-04 claim forms, EOBs, medical records, and supporting documentation, to determine the appropriate course of action.
• Utilize proprietary systems and client platforms to investigate claim status and facilitate resolution.
• Maintain familiarity with client-specific requirements, payer guidelines, and known reimbursement issues.
• Ensure compliance with HIPAA regulations and organizational privacy standards.

Team Support & Collaboration

• Facilitate communication of account findings, rebill outcomes, and recovery opportunities with auditors and internal stakeholders.
• Mentor, onboard, and train new Revenue Analysts and team members.
• Lead or assist with team training sessions and knowledge-sharing initiatives.
• Facilitate, document, and participate in internal team meetings.
• Collaborate with managers, project leads, and cross-functional teams to support client deliverables and department goals.

Project & Performance Management

• Manage multiple projects and account inventories while meeting established deadlines, productivity standards, and quality metrics.
• Monitor workload priorities and contribute to process improvement initiatives.
• Perform other duties as assigned.

MINIMUM QUALIFICATIONS & REQUIREMENTS:

• Associate’s Degree or 3-5 years relevant work experience preferred
• Knowledge of Revenue Cycle industry preferred
• Experience reviewing hospital claims and payor contracts
• Professional experience communicating with insurance companies verbally and writing complex appeals for contractual underpayments
• Comprehension of key risk areas of contract reimbursement methodologies
• Ability to conduct research via multiple channels (internet, client and payer systems, and internal resources
• Ability to navigate Hospital’s optical storage and patient accounting systems
• Critical thinking and decision-making skills
• Must be able multi-task and remain diligent with workload/multi-project while maintaining strong attention to detail
• Excellent written and verbal communication skills
• Strong computer skills, including OneNote, Word, Excel (advanced formulas, pivot tables)
• Ability to adapt to mentee learning style and adjust training accordingly
• Strong independent work ethic while also collaborating with a team to achieve goals

We Offer:

• Quality of life with a remote predictable, full-time schedule 

• Competitive compensation commensurate to experience

• Medical, Dental, Vision coverage and more

• Long-term disability insurance, and life insurance

• Ample parental leave

• 401K with company match

• Certification and Tuition Reimbursement

• Holidays, paid time off

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.