Carrier Revenue Analyst

Thank you for considering Progyny!

We are looking for a Carrier Revenue Analyst to join our Operations team. The ideal candidate will have at least one year of experience in healthcare Revenue Cycle Management (RCM) and a strong understanding of CPT and HCPC codes. Candidates should possess analytical abilities, strong verbal and written communication skills, and be self-starters who can work in a fast-paced, growing environment. This role offers an exciting opportunity to contribute to the success of a dynamic, high-performing team focused on claims and collections processes.

What you'll do...

• Analyze claims data using Excel and SQL to identify root causes of issues and recommend corrective action plans.

• Take ownership of key platforms that integrate external and internal data for customer and financial reporting.

• Assist in creating and maintain revenue and claims reports for key stakeholders within the Operations department.

• Assist in the preparation and delivery of standard monthly and quarterly reports with detailed analysis for various business partners.

• Reconcile claims payments to ensure accuracy and compliance with contractual obligations.

• Review claims to identify denials, underpayments, and billing issues, ensuring adherence to contracted reimbursement terms.

• Monitor and track billing, claims, and posting errors, providing ongoing feedback to the management team for continuous process improvement.

• Effectively communicate with both internal and external stakeholders to ensure follow-up on claims issues, escalating when necessary.

• Collaborate with team members to support mutual success and contribute to departmental goals.

• Ensure compliance with HIPAA, Billing Compliance, and other safety policies and guidelines.

About you...

• Bachelor's degree required.

• At least one year of experience in healthcare RCM, with knowledge of CPT and HCPC codes.

• One year of experience working with carrier/commercial payors, including claims denials, disputes, and appeals.

• Billing Specialist, Claims Analyst, or Backend RCM Specialist experience is a plus.

• Advanced proficiency in Microsoft Excel, with the ability to learn and adapt to new systems and programs.

• SQL knowledge is preferred.

• Excellent verbal and written communication skills.

• Highly motivated with a positive work ethic and the ability to work effectively in a fast-paced environment.

• Strong analytical skills with attention to detail, critical thinking, and problem-solving abilities.

• Ability to work collaboratively with diverse teams, demonstrating strong customer service skills and professionalism in all situations.

• Passion for claims review, business administration, and continuous improvement in healthcare operations.

Please note: Progyny is unable to provide visa sponsorship for this position. Candidates must be authorized to work in United States without the need for sponsorship, now or in the future.

In compliance with New York City's Wage Transparency Law, the annual salary [wage] range for NYC-based applicants is: $60,000 - $70,000. There are a variety of factors that go into determining a salary range, including but not limited to external market benchmark data, geographic location, and years of experience sought/required. Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.

Progyny is proud to be anEqual Opportunity and Affirmative Action employer.We respect and seek to empower each individual and support the diverse cultures, perspectives,skillsand experiences within our workforce. All qualified applicants will receive consideration for employment without regard to race, creed, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, marital status, 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 apply@progyny.com.

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