Carrier Revenue Analyst

Job description

Thank you for considering Progyny! We are seeking a detail-oriented and analytical Carrier Revenue Analyst to support backend Revenue Cycle Management (RCM) operations, with a strong focus on claims investigation, denial resolution, and revenue recovery. This role is responsible for deep-dive analysis of claims across commercial payors, identifying root causes of payment discrepancies, and driving resolution through internal remediation and external carrier engagement. The ideal candidate brings at least 1+ year of healthcare claims processing or RCM experience, with a strong foundation in claim adjudication workflows, denial management, and reimbursement methodologies. What you'll do... Perform detailed review of claims lifecycle (submission through adjudication) to identify denials, underpayments, recoupments, and processing errors Conduct root cause analysis across claim issues, including eligibility, COB, coding, billing, and payer policy misalignment Validate claims against contracted reimbursement terms, medical policies, and billing guidelines Investigate and categorize denials: Partner with internal teams and external payors to drive reprocessing, appeals, and corrections I...