Senior Medical Claims & Accounts Receivable Analyst

Job Category :
Clerical/Office

Requisition Number : INPAT
001203

• Posted :
  September 28, 2026
• Full-Time

Showing 1 location

Meeker, CO 81641, USA

Reports To:

Revenue Cycle Director

FLSA Classification:
Full-Time, Non-exempt, Hourly $26.22-$35.51

Senior Medical Claims and Accounts Receivable Analyst

onsite or remote

The ideal candidate will have advanced knowledge of medical coding, billing, insurance reimbursement, payer requirements, and claims processes . A professional certification in medical coding and/or billing is strongly preferred. This individual must be highly analytical, detail-oriented, persistent, and capable of independently researching and resolving complex claims issues.

Key Responsibilities

Accounts Receivable Management

• Manage and actively monitor assigned AR to ensure timely and accurate reimbursement.
• Analyze aging reports and prioritize accounts based on dollar value, age, payer, denial reason, and likelihood of recovery.
• Develop and execute effective strategies to reduce outstanding AR and prevent accounts from becoming significantly aged.
• Identify trends in unpaid, underpaid, and delayed claims.
• Maintain accurate documentation of collection activities, claim status, follow-up efforts, and payer communications.
• Escalate high-dollar, complex, or unresolved accounts appropriately.

Claims Analysis & Denial Resolution

• Conduct detailed reviews of rejected, denied, and underpaid medical claims to determine the root cause of nonpayment.
• Research payer policies, contracts, medical necessity requirements, coding guidelines, authorization requirements, and claim submission rules.
• Determine whether issues are related to coding, billing, authorization, eligibility, documentation, bundling, medical necessity, timely filing, payer processing, or other reimbursement requirements.
• Prepare and submit corrected claims, reconsiderations, appeals, and supporting documentation as appropriate.
• Follow claims through the resolution process and ensure appropriate payment is received.
• Identify recurring denial patterns and recommend corrective action to prevent future denials.
• Investigate ongoing payment discrepancies, including underpayments, incorrect contractual adjustments, partial payments, and unexplained nonpayment.
• Compare payer payments against expected reimbursement and contractual terms.
• Identify systematic payer or internal billing issues that may be negatively affecting revenue.
• Work with billing, coding, clinical, administrative, and payer teams to resolve complex reimbursement problems.
• Escalate persistent payer issues when appropriate and maintain detailed records of resolution efforts.
• Apply knowledge of ICD-10-CM, CPT, HCPCS, modifiers, NCCI edits, payer-specific requirements, and general coding/billing principles when analyzing claims.
• Review claims for potential coding or billing errors contributing to denials or payment delays.
• Collaborate with certified coders, billers, providers, and other revenue cycle personnel when additional expertise or documentation is required.
• Identify opportunities to improve claim accuracy and first-pass payment rates.

Reporting & Process Improvement

• Monitor key AR and claims metrics, including aging, denial rates, recovery rates, payment turnaround, and outstanding balances.
• Analyze trends and prepare reports identifying significant reimbursement problems.
• Recommend process improvements designed to increase collections, reduce denials, and improve cash flow.
• Assist in developing and maintaining denial-management and AR workflows.
• Identify opportunities for automation, workflow improvement, payer escalation, and staff education.
• Provide feedback to leadership regarding recurring payer, coding, billing, and reimbursement issues.

Required Qualifications

• Advanced experience in medical claims, billing, accounts receivable, or revenue cycle management.
• Strong understanding of the healthcare reimbursement and claims process.
• Demonstrated experience researching and resolving complex medical claim denials and payment issues.
• Strong knowledge of insurance payer processes and requirements.
• Excellent analytical, organizational, and problem-solving skills.
• Ability to manage a high-volume AR workload while maintaining accuracy and thorough documentation.
• Strong written and verbal communication skills.
• Ability to independently research problems and follow issues through to resolution.
• Proficiency with electronic medical records (EMR), practice management, billing,…