RCM Specialty Testing Revenue Analyst

Role Overview

• 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