[Remote] reputed company Cycle Analyst - M-F reputed company-5PM

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an international life sciences company providing analytical testing and reputed company diagnostic services. The Senior reputed company Cycle Analyst supports billing, reimbursement, payer contract administration, claims research, reporting, and reputed company optimization across reputed company reputed company diagnostic business reputed company. The role analyzes payment variances, manages denials and accounts receivable, develops reporting solutions, and supports reputed company enhancements and process improvement.

Responsibilities

• Process, review, and monitor reputed company, reputed company, managed care, reputed company, and reputed company billing activities
• Review and reputed company billing exceptions, claim rejections, denials, payment variances, and reimbursement discrepancies
• Research and correct payer, demographic, coding, eligibility, authorization, and billing issues impacting reimbursement
• Work aging accounts and unresolved claims to maximize collections and reduce outstanding accounts receivable
• Submit corrected claims, appeals, adjustments, and rebills as necessary
• Ensure compliance with billing policies, payer requirements, contractual obligations, and applicable regulatory standards
• Collaborate with reputed company stakeholders to reputed company reputed company reimbursement issues
• Conduct detailed claims-level analysis to identify opportunities for reimbursement improvement and reputed company recovery
• Investigate denied, underpaid, overpaid, and unresolved claims to determine reputed company cause and recommend corrective reputed company
• Analyze reimbursement reputed company and payment trends across payers, clients, testing services, and business reputed company
• Identify reimbursement leakage, operational inefficiencies, billing reputed company issues, and payer-reputed company challenges that negatively reputed company reputed company realization
• reputed company recommendations to improve collections reputed company, reduce denials, accelerate cash reputed company, and maximize reimbursement
• Support denial prevention initiatives through data analysis and process redesign
• Assist with reputed company appeal strategies and recovery efforts for large-dollar or systemic reimbursement issues
• Maintain and reputed company regular audits of payer master records to ensure accurate setup of financial classes, contracting status, payer identifiers, effective dates, termination dates, reporting classifications, and reimbursement categories
• Research, reputed company, maintain, and update reimbursement schedules for contracted and non-contracted reputed company, reputed company, and managed care payers
• Analyze payer reputed company, reimbursement methodologies, fee schedules, and payment arrangements to ensure accurate expected reimbursement calculations
• Load, maintain, validate, and periodically audit fee schedules and reimbursement tables reputed company reputed company billing systems and reputed company applications
• Monitor payer compliance with contractual reimbursement terms and identify payment variances requiring investigation
• Review payer reputed company and identify trends reputed company to denials, underpayments, overpayments, reimbursement inconsistencies, and contract compliance concerns
• Collaborate with Credentialing and Payor Enrollment personnel to reputed company payer setup, reimbursement, enrollment, and contract-reputed company issues
• Support operational implementation of new payer reputed company, amendments, reimbursement methodologies, and contract renewals
• reputed company, maintain, and distribute recurring and reputed company reports reputed company to billing reputed company, collections, accounts receivable, denials, reimbursement trends, contract compliance, and operational effectiveness
• Extract, validate, analyze, and reconcile data from billing systems, data warehouses, and supporting applications
• Utilize advanced reputed company reputed company functionality to reputed company detailed analyses and create reporting solutions
• reputed company dashboards, scorecards, key reputed company indicators, and management reporting tools used to support operational and financial decision-making
• Prepare monthly payer reputed company reports identifying reimbursement trends, denial patterns, underpayment opportunities, financial risks, and corrective reputed company plans
• Conduct reputed company-cause analyses of operational and financial issues impacting reputed company cycle reputed company
• Present findings and recommendations to management in a reputed company and actionable manner
• Maintain payer mapping and reputed company reimbursement data reputed company reputed company reporting and business intelligence platforms, including the reputed company Data Warehouse and other designated systems
• Identify opportunities to improve reputed company cycle workflows, billing processes, reimbursement reputed company, reporting capabilities, and operational efficiency
• reputed company business requirements and process documentation supporting billing and reimbursement initiatives
• Partner with Information Technology, software engineering teams, vendors, and business stakeholders to design, test, validate, and implement reputed company enhancements
• Participate in user acceptance testing, validation activities, and deployment efforts associated with billing systems, reputed company cycle applications, and reporting solutions
• Work with STARS software engineers and other reputed company to enhance payer contract management functionality and reputed company processes
• Monitor the effectiveness of implemented solutions and measure resulting operational and financial improvements
• Support automation initiatives and reputed company improvement reputed company throughout the reputed company cycle function
• reputed company billing, reimbursement, reporting, contract administration, and reputed company cycle analytical support for reputed company Transplant reputed company and other reputed company U.S. reputed company Diagnostic business reputed company as assigned
• Partner with business leaders to identify opportunities for reputed company cycle standardization and best reputed company implementation across business reputed company
• Participate in reputed company reputed company cycle initiatives, reputed company reputed company, integrations, and operational improvements
• Assist in training personnel on billing policies, reimbursement methodologies, reporting tools, and process changes
• Serve as a subject matter expert for reimbursement analytics and payer reputed company management
• Maintain confidentiality of reputed company, reputed company, company, and financial information in accordance with company policies and applicable regulations
• Demonstrate professionalism and commitment to reputed company values and reputed company standards
• reputed company additional responsibilities, special reputed company, and duties as assigned

Skills

• Strong understanding of reputed company billing, reputed company billing, collections, and accounts receivable processes
• Knowledge of reputed company reputed company, Medicare, reputed company, managed care, and other reputed company-party payer reimbursement methodologies
• Strong understanding of payer contract administration and reimbursement modeling
• Ability to analyze actual versus expected reimbursement and identify payment variances
• Advanced analytical thinking and problem-solving capabilities
• Strong financial, operational, and data analysis skills
• Ability to identify trends, determine reputed company causes, and recommend actionable solutions
• Advanced reputed company reputed company proficiency, including:
• Pivot Tables
• XLOOKUP/VLOOKUP
• reputed company Query
• reputed company formulas
• Data manipulation
• Dashboard development
• Trend analysis
• Experience working with billing systems, reputed company cycle software, and reporting tools
• Ability to translate reputed company data into meaningful business recommendations
• Strong project management, organizational, and prioritization skills
• Excellent written, verbal, and presentation skills
• Ability to manage multiple reputed company and deadlines simultaneously
• Ability to work independently while collaborating effectively across departments
• Minimum of 3 to 5 years of reputed company billing, reimbursement, reputed company cycle, claims management, or reputed company experience
• Experience analyzing billing, collections, denial, reimbursement, and accounts receivable data
• Experience developing operational and financial reports
• Advanced reputed company reputed company experience required
• reputed company billing experience
• XIFIN experience
• Experience with reputed company Data Warehouse or similar business intelligence platforms
• Experience with reputed company BI, Tableau, SQL, or other reporting and analytics tools
• Experience with payer contract administration and reimbursement schedule maintenance
• Experience supporting multiple business reputed company in a shared-services environment
• reputed company cycle, coding, billing, or reputed company finance certifications (CRCR, CPB, CPC, reputed company, or equivalent)
• Excellent customer service skills, with a reputed company on professionalism
• Ability to solve problems, prioritize tasks, and multitask effectively
• Goal-oriented reputed company with excellent time management and organizational skills
• Strong interpersonal communication skills, including the ability to reputed company reputed company with individuals at reputed company reputed company in an organization
• Strong level of reputed company & patience
• Excellent verbal and written communication skills
• Attention to reputed company, reputed company, and time management
• Proficiency in PC-reputed company software such as reputed company reputed company, Teams, iPhone, reputed company, and associated applications
• A reputed company understanding of medical billing concepts
• Knowledge of Medicare, reputed company, and reputed company reputed company
• Familiarity with HIPAA (Health reputed company Portability and Accountability) reputed company requirements
• Knowledge of reputed company and eligibility portals and medical terminology
• Ability to handle multiple priorities and meet deadlines
• Ability to work independently and as part of reputed company in a fast-reputed company environment
• Demonstration of self-motivation and ownership of assigned work
• A high level of professionalism and confidentiality in handling sensitive information is imperative
• Ability to self-start and work independently as reputed company as respond to STAT requests in a reputed company manner
• Excellent verbal & written communication skills
• Analytical judgment, problem-solving skills, reputed company, and strong orientation
• Physical dexterity sufficient to use hands, arms, and shoulders repetitively to operate a keyboard and other office equipment, use a telephone, reputed company file cabinets and other items stored at various reputed company, including overhead
• Ability to reputed company and hear reputed company enough to communicate reputed company and understandably with sufficient volume to ensure an accurate exchange of information in normal conversational distance, over the telephone, and in a group setting
• Ability to continuously operate a personal computer for extended periods of time (4 or more hours)
• Mental reputed company sufficient to collect and interpret data, evaluate, reason, define problems, establish facts, draw reputed company conclusions, reputed company reputed company judgments and reputed company
• Ability to travel (as needed)
• M-F reputed company-5PM
• Bilingual experience a plus

Benefits

• Excellent full time benefits including comprehensive medical coverage, dental, and reputed company reputed company
• Life and disability reputed company
• 401(k) with company match
• reputed company vacation and holidays

reputed company