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Senior Reimbursement Analyst – Denials/Appeals
LabcorpSenior Reimbursement Analyst leading the identification and strategic development of appeal opportunities for Labcorp. Utilizing advanced analytics and payer policy expertise to maximize reimbursement.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare revenue cycle management, including appeals and denials across commercial and government payers. Proficient in data analysis and interpretation to develop actionable appeal strategies and optimize reimbursement processes.
Highest-signal resume keywords
Healthcare Revenue Cycle ManagementData Analysis and InterpretationAppeal Strategy DevelopmentAdvanced Microsoft ExcelClinical or Coding Credentials
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Healthcare Revenue CycleDenial ManagementData Mining TechniquesClaims AnalysisBilling GuidelinesCPT/HCPCS CodingPayer Policy InterpretationPolicy ResearchReimbursement MethodologiesTrend Identification
Soft Skills
CollaborationProblem-SolvingCommunicationSubject Matter ExpertiseProcess Improvement
Tools & Technologies
Microsoft ExcelSQLTableauPower BISAS
Certifications & Qualifications
RNLPNMT/MLSCPCCCS
Industry Keywords
Payer PolicyMedical Necessity CriteriaLaboratory BillingDiagnosticsMolecular Testing
Tech Stack
Tools & technologiesSQLTableau
About the role
Key responsibilities & impact- Identify and prioritize high-value, scalable appeal opportunities across commercial and government payers
- Develop and standardize appeal strategies and frameworks based on payer policy, denial trends, and financial impact
- Draft complex or exemplar appeals to establish best practices and reusable templates
- Partner with operational teams to enable execution of appeals at scale , rather than performing routine claim-level submissions
- Analyze large healthcare datasets (claims, remittance, denial, and clinical data) to identify trends, root causes, and recovery opportunities
- Design and execute advanced data mining techniques to surface actionable insights and quantify financial impact
- Translate data insights into enterprise-level appeal strategies and recovery initiatives , not individual claim resolution
- Interpret payer policies, LCD/NCDs, and medical necessity criteria to assess appeal viability
- Apply knowledge of billing guidelines, coding (CPT/HCPCS), and reimbursement methodologies
- Identify policy misalignment and develop targeted appeal strategies or escalation approaches
- Partner with Revenue Cycle, Denial Operations, and Payor Solutions teams to address systemic denial issues
- Provide subject matter expertise and guidance on appeal strategy and policy interpretation
- Support process improvement initiatives aimed at reducing denials and optimizing reimbursement
Requirements
What you’ll need- Bachelor’s degree with 7+ years of experience in healthcare revenue cycle, reimbursement, or denial management OR Associate degree with 9 years of experience in healthcare revenue cycle, reimbursement, or denial management OR HS diploma or GED with 11 years of experience in healthcare revenue cycle, reimbursement, or denial management
- 7+ years of experience in healthcare revenue cycle, reimbursement, or denial management
- 5+ years of hands-on experience analyzing healthcare datasets, including claims, denials, and remittance data, with demonstrated ability to identify trends and actionable insight
- Advanced proficiency in Microsoft Excel, including large dataset manipulation and data analysis
- Direct experience managing appeals and denials across commercial and/or government payers, including tracking outcomes and driving resolution strategies
- Demonstrated experience drafting appeal letters with supporting clinical and policy rationale
- Strong knowledge of medical terminology and healthcare billing/coding concepts
- Proven ability to interpret payer policy language and translate policy criteria into actionable appeal strategies or reimbursement opportunities
- Experience with laboratory billing, diagnostics, or molecular/genetic testing
- Clinical or coding credentials (e.g., RN, LPN, MT/MLS, CPC, CCS)
- Experience with policy research or reimbursement optimization
- Advanced Microsoft Excel (required)
- SQL or similar data query tools (preferred)
- Data visualization tools (Tableau, Power BI) (preferred)
- Analytical tools (SAS) (preferred)
Benefits
Comp & perks- Medical
- Dental
- Vision
- Life
- STD/LTD
- 401(k)
- Paid Time Off (PTO) or Flexible Time Off (FTO)
- Tuition Reimbursement
- Employee Stock Purchase Plan