Sr. Revenue Cycle Analyst

ProgenyHealth, LLC

Revenue Cycle Analyst supporting payment integrity programs for health plans. Managing claims recovery, adjustment, invoicing, and reporting processes remotely with occasional office visits.

Posted 4/17/2026full-timePlymouth Meeting • Pennsylvania • 🇺🇸 United StatesSeniorWebsite

About the role

Key responsibilities & impact

The Revenue Cycle Analyst supports payment integrity programs for health plan clients
Managing the downstream financial and operational activities that occur after claim audit or validation
Tracking audited claims through recovery, adjustment, invoicing, and reporting processes to ensure identified savings are accurately realized, reconciled, and communicated
Manage post-audit claim inventory across multiple clients, products, and workflows (pre-pay, post-pay, Pre-ProgenyHealth NICU Claims Review)
Track claims from audit determination through recovery, adjustment, offset, or denial resolution
Reconcile client-reported recoveries, offsets, and adjustments to auditor findings
Identify and resolve discrepancies where recoveries do not directly align to original audit findings
Support recovery calculations when savings are not explicitly reported and must be derived from claims data
Coordinate the generation and tracking of audit determination letters, overpayment notifications, and related correspondence
Maintain letter trackers to support timing requirements, regulatory compliance, and client workflows
Respond to client inquiries related to recovered amounts, claim status, and financial outcomes
Prepare pre-invoice and invoice support documentation based on recovered or adjusted claim values
Partner with Finance to validate invoicing accuracy and timing
Support revenue recognition by ensuring recoveries meet contractual and audit criteria
Reconcile invoice totals to claim-level recovery detail
Produce recurring and ad hoc reports on recovery performance, inventory status, and financial outcomes
Maintain accurate claim-level documentation to support audits, appeals, reconsiderations, and client reporting
Track claim iterations, adjustments, reversals, and reconsiderations across multiple data feeds
Identify workflow gaps, data issues, or process inefficiencies impacting recovery realization
Collaborate with Audit, Coding, Clinical, Client Success, and Product teams to improve revenue cycle workflows
Participate in quality assurance reviews to ensure consistency, accuracy, and compliance

Requirements

What you’ll need

3+ years of experience in healthcare revenue cycle, payment integrity, claims operations, or recovery analytics
Strong understanding of post-pay and pre-payment claims review workflows
Experience working with health plans, TPAs, or healthcare vendors (payer-side experience preferred)
Proficiency analyzing medical claims data, adjustments, offsets, and recovery files
Advanced Excel skills; ability to reconcile complex datasets
Strong analytical, organizational, and problem-solving skills
Excellent written and verbal communication skills.
Experience supporting payment integrity, audit, or overpayment recovery programs (preferred)
Familiarity with DRG, inpatient, and high-dollar claim review concepts (preferred)
Knowledge of payer regulations and audit requirements (e.g., Medicare, Medicaid, commercial plans) (preferred)
Experience working in multi-client vendor environments with varied workflows (preferred)
Exposure to appeals, reconsiderations, or provider dispute processes (preferred)

Benefits

Comp & perks

Paid Time Off
Paid Parental Leave
Medical, dental, vision benefits
401K with company match
Short- and Long-Term Disability
Group Life Insurance
Tuition reimbursement
Casual work environment

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

healthcare revenue cyclepayment integrityclaims operationsrecovery analyticsmedical claims data analysisExcelreconciliationauditoverpayment recoveryDRG

Soft Skills

analytical skillsorganizational skillsproblem-solving skillswritten communicationverbal communication