RCM Specialty Testing Revenue Analyst
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Job Description
RCM Specialty Testing Revenue Analyst providing analytical and operational support for specialty testing billing. Collaborating with cross-functional teams to improve denial operations workflows and processes.
Responsibilities:
- Provide analytical and operational support for Specialty Testing accounts receivable and reimbursement to improve denial operations workflows and processes
- Research denials/claim issues for root cause and provide suggestions for resolution
- Manage internal override inventory for prompt resolution
- Serve as an internal conduit to gather, share, and report information related to specialty billing workflows, system behavior, and claims outcomes
- Research issues to determine impacted scope of claims and Coordinate with operations/reporting team to identify and quantify impacts
- Coordinate with operations/reporting team to develop and communicate workflow projects
- Learn and navigate multiple laboratory systems and billing platforms; apply system workflows to billing processes to ensure expected outcomes
- Conduct research, data mining, evaluation, and validation of complex specialty testing datasets to identify trends and support data‑driven decision‑making
- Manage information requests from cross‑functional stakeholders, keeping them informed of reimbursement issues and changes
- Exercise sound judgment in making decisions that have long‑term organizational impact
- Build and maintain datasets and databases for routine and ad hoc reporting
- Recommend new or improved workflows for complex billing processes to maximize cash collections
- Contribute to the development, documentation, and implementation of workflow processes (e.g., appeals, prior authorizations, specialty support activities)
- Proactively identify and resolve broad issues affecting specialty testing billing performance
- Collaborate across Revenue Cycle Management functions to drive improvements, enhance effectiveness, and promote best practices
- Apply diverse technical skills to understand laboratory systems, data structures, and workflows across Labcorp and specialty testing environments
- Translate LCLS/LCBS data for use in specialty testing analysis and projects (a plus)
- Support management and peers by taking on additional projects as needed
Requirements:
- Bachelor’s degree with 6 years’ healthcare billing experience or Associate degree with 8 years healthcare billing experience or HS diploma or GED with 10 years healthcare billing experience
- 3 or more years experience with MS Excel
- 3 or more years experience working with denials, appeals, underpayments, and payment variance analysis
- 3 or more years Accounts Receivables healthcare billing
- 3 or more years experience with CPT, ICD‑10, and HCPCS coding
- 3 or more years experience in Medicare, Medicaid, and commercial payer reimbursement methodologies
- 3 or more years experience in prior authorization, medical necessity, and payer denial
- 1 or more years Xifin RPM and BI experience
- Proficiency in Microsoft Excel, including PivotTables, lookups, and data analysis functions
- Experience analyzing and manipulating large datasets
Benefits:
- Medical
- Dental
- Vision
- Life
- STD/LTD
- 401(k)
- Paid Time Off (PTO) or Flexible Time Off (FTO)
- Tuition Reimbursement
- Employee Stock Purchase Plan
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