Carrier Revenue Analyst

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 Identify trends and systemic issues impacting reimbursement and recommend scalable remediation strategies Reconcile payments using 835/EOB data to ensure accurate posting and identify discrepancies Monitor and track unapplied cash, posting errors, and claim status gaps Act as a liaison between internal teams and external carriers Escalate and track issues with payors, ensuring timely follow-up and resolution Support client and leadership requests with clear, data‑driven summaries of claim performance Ensure adherence to HIPAA, billing compliance, and internal policies Contribute to process standardization and automation efforts to improve efficiency and reduce manual errors Participate in QA initiatives and continuous improvement of claims workflows Support rebill workflows by validating corrected claims and ensuring proper submission logic Analyze claims and financial data using Excel (required) and SQL (preferred) to uncover trends and performance gaps Develop and maintain reports and dashboards to track denial rates, first-pass resolution, net collection rate, and aging AR and recovery progress Provide actionable insights to leadership on revenue leakage and operational inefficiencies About You Bachelor’s degree or equivalent experience 1+ year of healthcare RCM or claims processing experience Working Knowledge Of Claims lifecycle (837, 835, 277/276, EOB interpretation) Experience working with commercial carriers (e.g., Aetna, Anthem, UHC, etc.) CPT/HCPCS coding Commercial payor workflows and adjudication logic Experience with denial investigation, appeals, and claims corrections Advanced proficiency in Microsoft Excel (pivot tables, formulas, data analysis) Experience in backend RCM functions such as denials management, payment reconciliation, or AR follow-up Extensive analytical and critical thinking skills with a focus on problem‑solving and root cause identification High attention to detail with the ability to manage large datasets and complex claim scenarios Effective communication skills, with the ability to translate findings into clear, actionable insights Ability to thrive in a fast‑paced, high-volume environment while maintaining accuracy Self‑starter mindset with ownership over assigned workstreams and outcomes Nice to Have Familiarity with SQL or data querying tools Familiarity with Clearinghouses, Provider Portals, SalesForce, Pharmacy (PBM), Medical claims Exposure to reporting tools such as Power BI Please note: This is not a digital nomad or remote international position; candidates must be based in the United States. Progyny is unable to provide visa sponsorship for this position. Candidates must be authorized to work in the United States without the need for sponsorship, now or in the future. Benefits Family friendly benefits: Paid family and parental leave, preconception, fertility and family building benefits (including egg freezing, IVF, and adoption support), family and pet care fund, and Parents’ Employee Affiliation Group Menopause and midlife care Health, dental, vision and life insurance options for employees and family Free in‑person, virtual and text‑based mental health and wellness support Paid time off, including vacation, sick leave, personal days and summer flex time Company equity Bonus program 401(k) plan with company match Access to on-demand legal and financial advice Learning and development programs to help you grow professionally and a mentorship program Company social events to include annual volunteer day and donation matching Flex days (3 days a week in the office) and onsite meals and snacks for employees reporting into our NY office In compliance with New York City's Wage Transparency Law, the annual salary range for NYC‑based applicants is $65,000 - $80,000. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity. Progyny is proud to be an Equal Opportunity and affirmative action employer. We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity, birth or biological sex, gender expression, national origin, disability, age, genetic information or pregnancy or related condition, status as a protected veteran, criminal history consistent with legal requirements or any other basis protected by law. If you are an individual with a disability and need assistance or an accommodation during the recruiting process, please send an e‑mail to View email address on click.appcast.io. #J-18808-Ljbffr