Senior RCM Data Analyst

Senior RCM Data Analyst at Labcorp, based in Burlington, NC with a hybrid work arrangement, focusing on advanced data analytics to support Revenue Cycle Management initiatives, reimbursement research, and operational insights.

Responsibilities

• Design and conduct large-scale analyses leveraging claim-level, laboratory, billing, and reimbursement data to advance RCM initiatives.
• Examine the end-to-end claim lifecycle from order placement to adjudication to uncover reimbursement opportunities, identify process gaps, and inform revenue optimization strategies.
• Identify, validate, integrate, and analyze data across diverse sources, including lab systems, billing platforms, payer transactions, policy sources, and internal databases.
• Apply payer policy requirements and reimbursement guidelines to detect trends affecting claim outcomes and payment performance using claim transaction data.
• Perform statistical sampling, predictive modeling, and trend analysis to inform operational decisions and mitigate risk.
• Utilize SAS, SQL, Access, VBA, Tableau, and other reporting tools to locate, validate, and analyze data.
• Translate analytical results into actionable recommendations that drive process improvements, optimize reimbursement, and protect revenue streams.
• Develop monitoring models and alert systems to detect process deviations, reimbursement risks, and system performance issues.
• Provide analyses and reports that inform prioritization, operational enhancements, and strategic initiatives.
• Support system control research and monitoring aimed at reducing revenue leakage and improving reimbursement outcomes.
• Assess system workflows, payer policies, and claim processing rules to identify opportunities for technology enhancements and changes to business rules.
• Recommend and assist in developing business rules tied to system changes, automation efforts, and RCM technologies.
• Perform testing and validation activities for system enhancements and process changes.
• Contribute to RCM policy initiatives involving payer engagement, acquisitions, industry groups, and improvements to reimbursement processes.
• Develop analyses using industry-standard data sources to back business solution initiatives and payer-related projects.
• Participate in cross-functional discussions on reimbursement policies, claim processing strategies, and operational initiatives.

Requirements

• Bachelor's degree in statistics, mathematics, informatics, computer science, information systems, or a closely related quantitative field plus 6 or more years of relevant experience.
• At least 5 years of experience performing data analytics in healthcare domains such as revenue cycle management, reimbursement, payer operations, laboratory services, or billing.
• Minimum 5 years of SQL experience for querying, validating, transforming, and analyzing large datasets.
• At least 3 years using SAS for statistical analysis, data management, and reporting.

Technologies

• SAS
• SQL
• Access
• VBA
• Tableau
• Microsoft Excel

Benefits

• Medical
• Dental
• Vision
• Life
• STD/LTD
• 401(k)
• Paid Time Off (PTO) or Flexible Time Off (FTO)
• Tuition Reimbursement
• Employee Stock Purchase Plan