Note: The job is a remote job and is open to candidates in USA. Labcorp is seeking a REMOTE Reimbursement Analyst III to join their team. This role is responsible for providing advanced analytical support related to third-party denials, reimbursement issues, and appeals initiatives while collaborating with Revenue Cycle Operations to implement process improvements that maximize revenue and ensure compliance with payor and regulatory guidelines.
Responsibilities
- Analyze third-party denial trends and reimbursement issues to identify root causes and recommend corrective actions
- Lead and support appeals initiatives, collaborating with Reimbursement Administrator, including identifying appeal opportunities, tracking outcomes, and collaborating with internal and external teams to improve success rates
- Conduct detailed analyses of data related to existing or proposed revenue cycle projects, including payor performance and denial resolution
- Develop and present findings through graphs, charts, written summaries, and presentations for leadership review
- Collaborate with Revenue Cycle Operations to identify areas for improvement and support the implementation of strategic projects
- Assist in the development and documentation of Standard Operating Procedures (SOPs) for denial management and appeals processes
- Manage the implementation of process improvements across the revenue cycle, ensuring alignment with organizational goals
- Provide timely and accurate updates to management on outstanding denial and appeal trends using defined systems and tracking mechanisms
- Ensure timely follow-up on unresolved issues to minimize business risks and revenue loss
- Stay current with payor guidelines, regulatory changes, and industry best practices related to reimbursement and appeals
- Perform other duties as assigned
Skills
- Bachelor's degree with 7 years' Healthcare Billing Systems experience and Payor and Policy experience and advanced analytics or Associate degree with 9 years Healthcare Billing Systems experience and Payor and Policy experience and advanced analytics or HS diploma or GED with 11 years Healthcare Billing Systems experience and Payor and Policy experience and advanced analytics required
- Proven analytical and critical thinking skills
- Excellent communication and presentation skills
- Ability to work independently and collaboratively in a fast-paced environment
- 5 or more years experience with payor contracts, medical terminology, commercial and government health insurance, billing guidelines, and appeals processes
- 3 or more years experience with SAS, Crystal Reports, Business Objects, or similar platforms
- 5 or more years advanced Microsoft Excel (formulas, pivot tables)
Benefits
- Medical
- Dental
- Vision
- Life
- STD/LTD
- 401(k)
- Paid Time Off (PTO) or Flexible Time Off (FTO)
- Tuition Reimbursement
- Employee Stock Purchase Plan
- Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan
- Employees who are regularly scheduled toworka 7 on/7 off schedule are eligible to receive all the foregoing benefits except PTO or FTO
Company Overview
Fortrea is a provider of comprehensive Phase I through IV clinical trial management, clinical pharmacology, patient access solutions. It was founded in 2023, and is headquartered in Durham, North Carolina, USA, with a workforce of 10001+ employees. Its website is https://www.fortrea.com.