Claims Revenue Analyst

Finance New York, New York


Description

We are looking for a Revenue Analyst to join our Finance team. You will be responsible for identifying claims reimbursement discrepancies, claims denials trends, underpayments to resolve root cause and submit appeals to insurance carriers for correct payment. The Revenue Specialist will provide analytical support for all collections processes and own the communication with healthcare payers, members, and internal stakeholders. The Claims and Member Revenue team is growing rapidly and is looking for motivated individuals to join their highly successful team.  

 
What you will do… 

  • Creating various revenue and claims reports for key stakeholders in the Finance department. 
  • Review claims to identify instances of denials and under payments in accordance with contracted reimbursement. 
  • Review and analyze “Explanation of Benefits” (EOBs) to identify under-allowed and denied claims. 
  • Monitors and tracks contractual, billing, claims, and posting errors, and provides continuous feedback to management team. 
  • Effectively communicate with internal and external stakeholder to perform routine follow-up and escalate issues as required. 
  • Compile and batch denied claims, or other pertinent criteria for expedited re-processing of claims. 
  • Analyze claims data and identify corrective action plans to address root issues. 
  • Maintain accurate records and reporting on account collection activity using Microsoft Excel 
  • Partners with fellow colleagues to support each other in their work to contribute to overall unit success. 
  • Conform to all applicable HIPAA, Billing Compliance and safety policies and guidelines.
 

About you… 

  • Requires bachelor’s degree or equivalent in education and experience. 
  • Must be a motivated individual with a positive and exceptional work ethic. 
  • Experienced in Microsoft Office (Word & Excel) or similar software is required, and an ability and willingness to learn new systems and programs. 
  • SQL knowledge is a plus, but not required. 
  • Excellent verbal and written communication skills 
  • Ability to work collaboratively with a diverse team, strong customer service skills, demonstrating tact and sensitivity in stressful situations. 
  • Excellent analytical skills: attention to detail, critical thinking ability, decision making, and researching skills to analyze a question or problem and reach a solution. 
  • Knowledge of billing and claims procedures and claims collection techniques welcomed. 
  • Individuals who have passion for finance and business administration

About Progyny:   

Progyny is a leading fertility benefits management company in the US. We are redefining fertility and family building benefits, proving that a comprehensive and inclusive fertility solution can simultaneously benefit employers, patients, and physicians. Our benefits solution empowers patients with education and guidance from a dedicated Patient Care Advocate (PCA), provides access to a premier network of fertility specialists using the latest science and technologies, reduces healthcare costs for the nation’s leading employers, and drives optimal clinical outcomes. We envision a world where anyone who wants to have a child can do so.   

Our mission is to make any member’s dream of parenthood come true through a healthy, timely, and supported fertility and family building journey.  

Come join a company that’s been recognized by Modern Healthcare as one of the Best Places to Work in Healthcare.  

 

Our perks: 

  • Family friendly benefits: Paid maternity and paternity, fertility benefits (including egg freezing and IVF), emergency childcare program, parent’s group  
  • Health, dental, vision and life insurance options for employees and family  
  • Paid vacation and summer flex time  
  • Company equity  
  • Bonus program  
  • 401K Match  
  • Company social events  
  • Sit/ stand desks   
  • Flex days (3 days a week in the office) for positions located at NY office  

Progyny is an Equal Opportunity Employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce.