Progyny

Progyny

Carrier Revenue Analyst

New York, New York

No sponsorship$65k-$70kDetected 4 days ago
SQLData AnalysisData VisualizationComplianceSalesforceExcelProcess ImprovementAR/VRHIPAALeadershipCommunicationCollaborationProblem SolvingCritical ThinkingMentoringClaims Management

About the role

  • 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.
  • The Carrier Revenue Analyst will directly contribute to operational excellence by identifying inefficiencies, strengthening payer relationships, and driving measurable financial outcomes.

Responsibilities

  • Perform detailed review of claims lifecycle (submission through adjudication) to identify denials, underpayments, recoupments, and processing errors
  • Partner with internal teams and external payors to drive reprocessing, appeals, and corrections
  • Support client and leadership requests with clear, data-driven summaries of claim performance
  • Support rebill workflows by validating corrected claims and ensuring proper submission logic
  • Develop and maintain reports and dashboards to track:
  • We respect and seek to empower each individual and support the diverse cultures, perspectives, skills and experiences within our workforce.

Requirements

  • Bachelor's degree or equivalent experience
  • Working knowledge of:
  • Experience working with commercial carriers (e.g., Aetna, Anthem, UHC, etc.)
  • 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:
  • 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
  • Familiarity with SQL or data querying tools
  • Candidates must be authorized to work in United States without the need for sponsorship, now or in the future.

Nice to have

  • Conduct root cause analysis across claim issues, including eligibility, COB, coding, billing, and payer policy misalignment
  • Investigate and categorize denials
  • 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
  • Ensure adherence to HIPAA, billing compliance, and internal policies
  • Contribute to process standardization and automation efforts to improve efficiency and reduce manual errors

Compensation

  • Company social events to include annual volunteer day and donation matching
  • In compliance with New York City's Wage Transparency Law, the annual salary [wage] range for NYC-based applicants is: $65,000 - $70,000.

Benefits

  • 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
  • Learning and development programs to help you grow professionally and a mentorship program
  • 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
  • Progyny offers a total compensation package comprised of base salary, cash bonus, and equity.

Equal opportunity

  • Equal Opportunity and Affirmative Action employer.
  • 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.

Visa & Work Authorization

  • Please note: Progyny is unable to provide visa sponsorship for this position.
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This listing is sourced directly from Progyny's careers page and normalized into a canonical job model.