Revenue Cycle & Payer Performance Analyst

Job Description

Job Description

Revenue Cycle and Payer Performance Analyst

Full Time / 35 Hours

Location: Bridgewater, MA

Hourly Pay: $35.00-$40.00

Schedule: This is a primarily Monday–Friday, daytime position, with schedule flexibility required 2–3 days per week to provide evening coverage. The position requires regular on-site presence during peak program hours to ensure effective support of program operations.

About Us

Easterseals Massachusetts is a leading nonprofit organization committed to ensuring that children and adults with disabilities have equal opportunities to live, learn, work, and play. Join our team and use your healthcare revenue cycle expertise to help strengthen the services and programs that make a meaningful difference in people’s lives.

The Bridge Center is a fully accessible, 51-acre campus in Bridgewater, Massachusetts, offering therapy, recreation, and equine-assisted programs for individuals of all ages and abilities.

About the Role

Easterseals Massachusetts is seeking an experienced Revenue Cycle and Payer Performance Analyst to serve as a key operational resource for insurance reimbursement and revenue cycle performance within Therapeutic Services at The Bridge Center.

In this role, you will independently submit claims, investigate complex reimbursement issues, manage payer denials and appeals, monitor revenue cycle performance, and translate payer requirements into practical processes that support compliant billing and appropriate reimbursement. You will collaborate with clinical, operational, and Finance teams to identify barriers to payment, improve workflows, reduce recurring denials, and strengthen revenue capture.

This is an excellent opportunity for an analytical, solutions-focused revenue cycle professional who enjoys solving complex payer issues, advocating for reimbursement, and creating sustainable process improvements.

Job Responsibilities

• Serve as a departmental subject-matter resource on payer requirements, reimbursement processes, billing rules, and operational impacts.
• Research and interpret payer policies, billing guidance, provider communications, authorization requirements, and reimbursement changes.
• Investigate complex denied, rejected, underpaid, or unresolved claims and identify the appropriate resolution strategy.
• Prepare and manage corrected claims, reconsiderations, formal appeals, documentation submissions, payer escalations, and follow-up.
• Communicate directly with payer representatives regarding disputed, delayed, or complex reimbursement matters.
• Analyze denial patterns, accounts receivable aging, clean claim performance, payment variances, underpayments, appeal recovery, and reimbursement trends.
• Identify root causes of reimbursement barriers and implement corrective workflows designed to reduce recurring denials and revenue leakage.
• Translate payer requirements into clear procedures, documentation practices, billing workflows, reference resources, and staff guidance.
• Provide leadership with reporting and analysis of revenue cycle performance, payer issues, financial risks, and recovery opportunities.
• Prioritize recovery efforts based on financial impact, filing deadlines, likelihood of recovery, and operational risk.
• Oversee insurance verification, referrals, prior authorizations, reauthorizations, and payer-specific documentation requirements.
• Manage provider enrollment, credentialing, recredentialing, revalidation, and payer record updates.
• Partner with clinical, operational, Human Resources, and Finance teams to support compliant and effective revenue cycle practices.
• Respond to complex patient and family billing questions with clarity, professionalism, and respect.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Finance, Health Information Management, or a related field preferred. Significant directly relevant healthcare revenue cycle experience may substitute for formal education.
• At least five years of progressively responsible experience in healthcare revenue cycle, reimbursement, medical billing, payer relations, or a related area.
• Advanced working knowledge of commercial insurance and public payer reimbursement processes.
• Demonstrated experience resolving complex claims, denials, appeals, underpayments, authorization issues, and reimbursement barriers.
• Experience interpreting payer requirements and translating them into operational processes, written procedures, and staff guidance.
• Strong understanding of claims processing, EOBs and ERAs, payer portals, authorizations, referrals, credentialing, provider enrollment, and timely filing requirements.
• Experience analyzing accounts receivable, denial trends, payment variances, and other revenue cycle performance data.
• Demonstrated ability to conduct root-cause analysis, develop corrective action, implement workflow improvements, and evaluate results.
• Strong written, verbal, analytical, organizational, and problem-solving skills.
• Ability to independently prioritize financially significant issues while knowing when to escalate material concerns.
• Proficiency with Microsoft Office, electronic record systems, insurance portals, clearinghouse tools, and billing software.

Preferred Qualifications

• Experience working with Massachusetts commercial health plans and MassHealth.
• Familiarity with Blue Cross Blue Shield of Massachusetts, Point32Health, Harvard Pilgrim Health Care, Tufts Health Plan, Mass General Brigham Health Plan, or other Massachusetts payers.
• Experience in outpatient Physical Therapy, Occupational Therapy, Speech-Language Pathology, pediatric rehabilitation, or a comparable healthcare environment.
• Experience with provider credentialing and payer enrollment.
• Experience supporting children and adults with disabilities and their families.
• CPC, CPB, CRCR, or a comparable healthcare revenue cycle, billing, coding, or finance credential.

Work Environment

This position is primarily based in an office setting at The Bridge Center and may require work across the campus as operational needs arise. The role requires schedule flexibility, including scheduled evening coverage, and may offer occasional remote work depending on departmental needs and job performance. Occasional in-state travel may also be required.

At Easterseals MA, we champion an environment where every employee feels valued and respected. We welcome everyone’s unique perspectives and strive to dismantle barriers that hinder individuals from reaching their full potential.

We actively engage with our staff, volunteers, partners, and the broader community to promote understanding, empathy, and collaboration. Collectively, we are changing the way the world defines and views disability, making profound and positive differences in people’s lives every day. By beginning with our own workforce, we demonstrate our commitment throughout the commonwealth.

Together, we can create a workplace where everyone thrives by ensuring all feel empowered and valued.

Easterseals Massachusetts is an Equal Employment Opportunity employer and welcomes all qualified applicants. We base all employment decisions on each individual’s capabilities and qualifications without regard to race, color, religious creed, national origin, ancestry, sex, sexual orientation, gender identity, age, physical or mental disability, veteran status, genetics, or any other legally protected characteristic.