Hospital Revenue Recovery Analyst

Company Description

Audley Law Offices, Partnered with Audley Recovery Solutions LLC, represents hospitals and health systems in complex reimbursement and revenue recovery matters. We specialize in resolving high-dollar, high-complexity claims involving payer denials, coordination of benefits (COB), delayed payments, and legally escalated recovery efforts. Our work sits at the intersection of hospital revenue cycle management and legal advocacy, requiring strong investigative and analytical skills to identify root causes of non-payment, interpret payer policy, and partner closely with providers to protect earned revenue through a patient-centered, professional, and compliance-driven approach. 

Role Description

The Revenue Cycle Analyst is responsible for independently managing and resolving complex hospital claims that require advanced analysis, payer engagement, and strategic follow-up. This role is designed for professionals with 3–5 years of hospital billing or revenue cycle experience who are comfortable working denials, appeals, COB issues, and escalations with minimal supervision.   This candidate will be groomed to be a liaison with leadership at health systems and Audley Revenue Solutions. 

Key Responsibilities 

Claim Resolution & Appeals

• Manage a caseload of complex, high-value hospital claims involving denials, COB, and delayed reimbursement. 
• Analyze EOBs, denial codes, payer correspondence, and hospital billing records to identify root causes of non-payment. 
• Execute resolution strategies including appeals, resubmissions, escalations, and legal referrals. 
• Communicate directly with payers, TPAs, patients, and legal representatives as needed. 
• Track claim status and document all activity in internal systems and payer portals. 

Correspondence & Documentation 

• Draft customized appeal letters, billing inquiries, and escalation correspondence. 
• Prepare claim summaries and supporting documentation for attorney review. 
• Maintain clear, accurate case notes and documentation in compliance with HIPAA and PHI standards. 

Client & Internal Coordination 

• Provide claim updates and issue escalation support to hospital clients and internal leadership. 
• Participate in reporting, reconciliations, and account reviews. 
• Flag trends, recurring denials, or outlier claims requiring additional attention. 

Analysis & Process Improvement 

• Identify coding, billing, or payer policy issues impacting reimbursement. 
• Conduct cross-system reviews (EMR, payer records, patient information) to support appeal strategy. 
• Contribute to workflow refinement, templates, and best practices. 
• Support mentoring or knowledge-sharing with junior staff as needed. 

Required Qualifications

• 3–5 years of experience in hospital billing, revenue cycle, or claims resolution. 
• Proven experience handling denials, appeals, and payer follow-up beyond basic claim submission. 
• Strong understanding of EOBs, denial codes, COB rules, and reimbursement processes. 
• Excellent written and verbal communication skills. 
• Strong organizational skills and attention to detail. 
• Proficiency with Microsoft Word, Excel, Outlook, and PDF tools. 
• Understanding of HIPAA and secure data handling practices. 

Preferred Qualifications 

• Experience with hospital billing systems EPIC. 
• Familiarity with payer portals (e.g., Availity, NaviNet, Medicare DDE). 
• Working knowledge of ICD-10, CPT, and HCPCS coding. 
• Experience supporting legally escalated claims or working with attorneys. 
• Power BI or other metric platform knowledge a plus.  
• PowerPoint presentation skills 

Why Join Us 

• Work on challenging, non-routine claims that require critical thinking and strategy. 
• Collaborate with attorneys, senior analysts, and hospital leadership. 
• Be part of a team that values accuracy, professionalism, and accountability. 
• Contribute directly to protecting hospital revenue and resolving complex payer issues.