Senior Analyst, Revenue Cycle Management

Remote Hours: Monday - Friday, 7:00 AM - 3:30 PM PST (or based on business needs)

The Analyst Team Lead serves as the senior operational resource for the AR Analyst Payer Pod team, providing technical expertise, daily guidance, and workflow support while performing advanced accounts receivable functions. This role is a step above the AR Analyst role and is responsible for serving as the team's subject matter expert (SME) for billing, claims resolution, payer requirements, and departmental processes.

The Analyst Team Lead works under a supervisor to ensure productivity, quality, compliance, and service goals are achieved. They mentor team members, assist with complex account issues and escalations, provide ongoing coaching and training, and promote consistent adherence to company policies, procedures, and best practices. While this position does not have direct supervisory authority, it plays a critical leadership role in supporting team performance and operational success.

Responsibilities

- Serves as the primary subject matter expert (SME) for Accounts Receivable processes, billing regulations, payer requirements, and claims resolution.

- Provides day-to-day leadership, guidance, and technical support to AR Representatives to ensure quality, productivity, and service expectations are consistently met.

- Acts as the first point of escalation for complex billing, claims, payer, and account issues that require advanced knowledge or resolution.

- Partners with Supervisor to monitor team performance, identify workflow improvements, and support departmental initiatives.

- Provides ongoing coaching, mentoring, and training to team members while reinforcing best practices and process consistency.

- Assists leadership with monitoring productivity, quality metrics, policy compliance, and performance expectations.

- Supports leadership by documenting performance observations, providing recommendations, and assisting with personnel-related matters as appropriate.

- Leads or coordinates departmental escalation projects, ensuring timely resolution of high-priority accounts and client concerns.

- Investigates, analyzes, and resolves complex insurance claims, including denials, appeals, underpayments, and reimbursement issues.

- Processes and follows up on insurance claims to ensure timely and accurate reimbursement.

- Oversees denial and appeal management to maximize reimbursement and minimize revenue loss.

- Manages assigned billing and work queues, ensuring accounts are prioritized and worked within established timelines.

- Investigates payer responses and updates patient accounts with accurate insurance, Medicare, and billing information.

- Exercises sound judgment when reviewing account information and making appropriate billing or account updates.

- Maintains accurate, detailed, and compliant account documentation within company systems.

- Identifies process improvement opportunities and provides recommendations to leadership to improve efficiency, quality, and revenue cycle performance.

- Adapts quickly to evolving payer requirements, regulatory changes, and departmental processes.

- Demonstrates professionalism, accountability, and reliability while fostering a collaborative and positive team environment.

- Attends and actively participates in departmental, cross-functional, and company meetings.

- Consistently meets or exceeds departmental quality, productivity, and service standards.

- May perform any additional responsibilities or special projects as required.

- Duties and responsibilities may be subject to change based upon the needs of the department.

- May provide cross-functional support as business needs demand.

Qualifications

- High School diploma or equivalent

- 3 years’ experience with insurance billing and processing claims preferred

- 3 years’ experience with Medicare claims, and Medicare and private insurance verification preferred

- Knowledge of insurance portals; familiarity with a