Revenue Cycle Analyst MF AM

Basic Function and Scope of Responsibility:

The Senior Revenue Cycle Analyst is responsible for performing revenue cycle, billing, reimbursement, payer contract administration, and analytical functions designed to maximize reimbursement, improve collections performance, reduce denials, and optimize revenue cycle processes across Eurofins Transplant Genomics, LLC and other Eurofins U.S. Clinical Diagnostic business units as assigned.

This role combines traditional billing and accounts receivable responsibilities with advanced analytical and business support functions. The Revenue Cycle Analyst serves as a subject matter expert in claims research, payer reimbursement methodologies, contract administration, revenue cycle reporting, underpayment recovery, denial management, and process improvement. The position utilizes laboratory billing systems, data warehouses, reporting tools, and advanced Excel-based analytics to identify reimbursement opportunities, investigate payment variances, develop management reporting, and support implementation of operational and system enhancements.

This individual works closely with Billing Operations, Finance, Credentialing, Payor Enrollment, Information Technology, Sales, Client Services, and Business Leadership to improve revenue cycle performance and ensure optimal reimbursement outcomes.

• Process, review, and monitor commercial, government, managed care, client, and patient billing activities.
• Review and resolve billing exceptions, claim rejections, denials, payment variances, and reimbursement discrepancies.
• Research and correct payer, demographic, coding, eligibility, authorization, and billing issues impacting reimbursement.
• Work aging accounts and unresolved claims to maximize collections and reduce outstanding accounts receivable.
• Submit corrected claims, appeals, adjustments, and rebills as necessary.
• Ensure compliance with billing policies, payer requirements, contractual obligations, and applicable regulatory standards.
• Collaborate with internal and external stakeholders to resolve complex reimbursement issues.

• Conduct detailed claims-level analysis to identify opportunities for reimbursement improvement and revenue recovery.
• Investigate denied, underpaid, overpaid, and unresolved claims to determine root cause and recommend corrective action.
• Analyze reimbursement outcomes and payment trends across payers, clients, testing services, and business units.
• Identify reimbursement leakage, operational inefficiencies, billing system issues, and payer-related challenges that negatively impact revenue realization.
• Develop recommendations to improve collections performance, reduce denials, accelerate cash flow, and maximize reimbursement.
• Support denial prevention initiatives through data analysis and process redesign.
• Assist with complex appeal strategies and recovery efforts for large-dollar or systemic reimbursement issues.

• Maintain and perform regular audits of payer master records to ensure accurate setup of financial classes, contracting status, payer identifiers, effective dates, termination dates, reporting classifications, and reimbursement categories.
• Research, develop, maintain, and update reimbursement schedules for contracted and non-contracted commercial, government, and managed care payers.
• Analyze payer contracts, reimbursement methodologies, fee schedules, and payment arrangements to ensure accurate expected reimbursement calculations.
• Load, maintain, validate, and periodically audit fee schedules and reimbursement tables within laboratory billing systems and related applications.
• Monitor payer compliance with contractual reimbursement terms and identify payment variances requiring investigation.
• Review payer performance and identify trends related to denials, underpayments, over payments, reimbursement inconsistencies, and contract compliance concerns.
• Collaborate with Credentialing and Payor Enrollment personnel to resolve payer setup, reimbursement, enrollment, and contract-related issues.
• Support operational implementation of new payer contracts, amendments, reimbursement methodologies, and contract renewals.

• Develop, maintain, and distribute recurring and ad hoc reports related to billing performance, collections, accounts receivable, denials, reimbursement trends, contract…