RCM Analyst

Verse

RCM Analyst focused on denial analysis and process improvements in the revenue cycle. Collaborating across teams to resolve issues and enhance revenue integrity.

Posted 5/27/2026full-timeNew York City • New York • 🇺🇸 United StatesMid-LevelSenior💰 $130,000 - $150,000 per yearWebsite

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Analyze denial patterns across payers, HCPCS codes, and product lines to identify systemic root causes to aid in the development of actionable remediation strategies.
Conduct direct payer outreach, calling insurance representatives, and escalating cases to discover the root cause of denials and underpaid claims.
Build and maintain denial, issue, and project tracking dashboards and reporting packages that give leadership a clear view of denials, causes, and the ongoing work to fix the denials.
Develop methodologies in coordination with the head of RCM for denial prioritization.
Perform root cause analysis on high-volume and high-dollar denials, documenting findings and presenting recommendations.
Partner with coders, billers, and front-end staff to share insights and reduce revenue leakage through upstream gaps contributing to recurring denials (eligibility, auth, coding, documentation).
Monitor payer policy changes and updates, flagging impacts to current billing practices and advising on workflow adjustments.
Collaborate with product and engineering to provide detailed insights into the root cause of denials and assist in crafting solutions.

Requirements

What you’ll need

3–6 years in RCM, with at least 1–2 years in a consulting or advisory capacity.
Demonstrated experience working denials across commercial, Medicare, and Medicaid payers.
Track record of calling payers directly, navigating payer portals, and managing the appeals lifecycle end-to-end.
Proficiency in Excel / Google Sheets for data manipulation and pivot analysis.
Familiarity with payer portals such as Availity.
Familiarity with SQL.
Experience with reporting tools or BI platforms.
Working knowledge of CPT, ICD-10, and HCPCS coding conventions.
Exceptional attention to detail. You catch what others miss.

Benefits

Comp & perks

Competitive benefits
Professional development opportunities
Work-life balance support

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

root cause analysisdata manipulationpivot analysisdenial managementcoding conventionsreporting toolsBI platformsExcelGoogle SheetsSQL

Soft Skills

attention to detailcollaborationcommunicationproblem-solvinganalytical thinking