We’re looking for a Senior Reimbursement Analyst to join our laboratory revenue cycle team, focused entirely on pre-claim accuracy and reimbursement readiness
Act as the final quality gate before claims are submitted
Ensure patient data, eligibility, coding, and medical necessity are correct so claims move cleanly through TELCOR, clearinghouses, and payer systems
Review lab orders and patient records to identify missing or conflicting demographic, insurance, or clinical data
Validate CPT and diagnosis alignment to meet payer medical necessity requirements
Ensure ordering provider information (NPI, credentials, facility details) is complete and accurate
Proactively resolve coverage and data issues before claims are generated
Verify insurance eligibility using 270/271 transactions, payer portals, and integrated tools
Identify and resolve inactive coverage, invalid policy numbers, and payer mismatches
Review claim acknowledgments, clearinghouse reports, and payer responses
Analyze and resolve pre-submission rejections related to formatting, coding, or payer edits
Work with clearinghouse partners to troubleshoot recurring rejection patterns
Use TELCOR to review claims, data feeds, file processing issues, and mapping errors
Troubleshoot order imports, payer mapping, demographic ingestion, and coverage files
Contribute to reporting, dashboards, or automated audits that improve claim quality

Required Experience in laboratory billing, reimbursement, or pre-claim operations
Hands-on experience working with TELCOR (RCS or QML)
Strong understanding of eligibility, benefits, and payer requirements
Ability to analyze pre-claim issues and identify root causes
Comfort working with data and systems to validate claim accuracy
SQL experience for data validation or reporting (Preferred)
Familiarity with EDI / HL7 workflows (270/271, 837, 835) (Preferred)
Experience in molecular, toxicology, or high-volume lab environments (Preferred)
Experience building audits or automated checks (Preferred)

Senior Reimbursement Analyst – Laboratory Billing

Key skills