Senior Reimbursement Analyst – Laboratory Billing
The Health Alliance
full-time
Posted on:
Location Type: Remote
Location: North Carolina • United States
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Job Level
Tech Stack
About the role
- Act as the final quality gate before claims are submitted, ensuring accuracy
- Review lab orders and patient records for missing/conflicting data
- Validate CPT and diagnosis alignment for payer requirements
- Proactively resolve coverage and data issues before claims are generated
- Verify insurance eligibility using transactions, portals, and tools
- Analyze claims, and resolve pre-submission rejections
- Use TELCOR to review claims, troubleshoot data issues
- Collaborate with teams to improve claim quality and operational efficiency
- Utilize SQL for data analysis and reporting
Requirements
- 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
- Preferred (Not Required) SQL experience for data validation or reporting
- Familiarity with EDI / HL7 workflows (270/271, 837, 835)
- Experience in molecular, toxicology, or high-volume lab environments
- Experience building audits or automated checks
Benefits
- Fully remote role with a specialized, high-impact focus
- Opportunity to influence front-end revenue quality, not just fix denials
- Collaborative environment with IT, billing, and analytics teams
- Work that directly improves reimbursement outcomes and operational efficiency
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
SQLCPT codingdata analysisclaims analysisdata validationautomated checksauditingeligibility verificationreimbursement processespre-claim operations
Soft Skills
collaborationproblem-solvingattention to detailanalytical thinkingcommunication