RCM Payor Analyst: Denials & Revenue Recovery

Brightree by Resmed; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Brightree by ResMed is seeking an RCM AR Payor Analyst to own the revenue cycle performance for a portfolio of healthcare clients, focusing on reimbursement optimization and denial prevention. You will work with payors and client teams to resolve AR issues and improve cash flow.

The role emphasizes data analysis, trend identification, and collaboration across departments to ensure accurate billing, HIPAA compliance, and measurable outcomes.

Qualifications

• 2+ years of DME/HME Revenue Cycle Management experience.
• Experience managing accounts receivable, denials, appeals, and reimbursement resolution activities.
• Strong knowledge of Medicare, Medicaid, and Commercial payer billing and reimbursement requirements.
• Experience conducting trend analysis, root cause investigations, and identifying revenue cycle improvement opportunities.
• Ability to present findings, recommendations, and performance insights to clients and leadership.
• Excellent written, verbal, and presentation communication skills.
• Proficiency with Microsoft Office applications, particularly Excel.
• Working knowledge of HIPAA and healthcare compliance requirements.
• Experience collaborating across departments to support operational and customer-focused initiatives.
• Demonstrated ability to work independently and drive issues through resolution.

Responsibilities

• Own the revenue cycle performance of assigned clients, serving as the primary operational contact and ensuring timely resolution of issues, risks, and escalations.
• Drive reimbursement outcomes through proactive accounts receivable management, denial resolution, appeals support, and revenue recovery activities.
• Analyze payor and client data to identify trends, root causes, risks, and opportunities that improve financial performance.
• Partner with global operations teams to monitor inventory, quality, productivity, and SLA adherence, ensuring consistent customer outcomes.
• Develop and maintain provider guides, SOPs, and client-specific process documentation that improve operational consistency and team effectiveness.
• Educate internal teams on reimbursement requirements, workflows, and best practices to reduce denials and improve revenue cycle performance.
• Recommend and implement process, workflow, payer setup, and pricing improvements that maximize reimbursement and increase efficiency.
• Lead cross-functional collaboration to resolve operational challenges, remove barriers, and support client success.
• Prepare and present reporting, deep-dive analyses, and recommendations that enable informed business decisions and stronger customer outcomes.
• Monitor compliance with Medicare, Medicaid, Commercial payer requirements, HIPAA, and internal policies while escalating identified risks when needed.
• Maintain end-to-end ownership of action plans and customer outcomes, ensuring issues are resolved through completion.

Skills

Analytical thinking

Problem-solving

Communication skills

Time management

Independent ownership

Collaboration

Education

Associate's degree

Bachelor's degree

Tools

Excel

Brightree

Job description

Brightree by ResMed is seeking an RCM AR Payor Analyst to own the revenue cycle performance for a portfolio of healthcare clients, focusing on reimbursement optimization and denial prevention. You will work with payors and client teams to resolve AR issues and improve cash flow.

The role emphasizes data analysis, trend identification, and collaboration across departments to ensure accurate billing, HIPAA compliance, and measurable outcomes.