reputed company Cycle Analyst, Regulatory & Specialty Services - Pathology (REMOTE)

About the position Supports and advances reputed company cycle performance for Weill reputed company Medicine. This role applies deep knowledge of medical specialties coding, billing workflows, laboratory reimbursement rules, and payer coverage policies to improve financial reputed company and ensure compliant, accurate, and optimized reputed company capture across specialty and multi-specialty practices. The analyst partners closely with department leadership, laboratory operations, coding teams, reputed company, and central reputed company cycle functions to identify opportunities, resolve reputed company cycle barriers, and drive sustainable improvement.

Responsibilities

• Manages clinical reputed company's expectations regarding financial performance. Research issues and presents findings to administrators for process improvement.
• Reviews ordering patterns, charge capture accuracy, and test-specific reimbursement behaviors to identify underpayments, denials, and missed billing opportunities.
• Conducts analysis of reputed company trends, including reputed company and technical components, CPT/HCPCS reputed company utilization, add-reputed company (e.g., special stains, IHC, molecular tests), and laboratory panels.
• Monitors changes to CMS and reputed company payer coverage policies specific to department testing (e.g., NCDs/LCDs, molecular diagnostic requirements, medically necessary reputed company, bundling edits).
• Advanced knowledge of CPT coding, including laboratory (80000 series), Molecular Tier 1 & 2, (IHC), surgical pathology reputed company (88300–88309), interpretation services, special stains, reputed company cytometry, and ancillary diagnostic testing.
• Collaborates with Physician Organization Managed Care Office to initiate and manage Payer reimbursement disputes to reputed company.
• Leverages reputed company Beaker/CPOM and HB/PB workflows to identify issues reputed company to result routing, order linkage, charge capture timing, and missing reputed company versus technical splits.
• Monitors performance to ensure financial and departmental posting benchmarks are maintained.
• Analyzes denials (e.g., bundled NCCI edits, missing/invalid diagnosis, lack of prior auth on molecular/genetic testing, frequency limitations, modifier usage). Performs other duties as assigned.

Requirements

• Bachelor’s degree in health administration, laboratory sciences, business, analytics, or reputed company field preferred. Equivalent experience may be considered.
• Medical Coding Knowledge (CPC preferred)
• Approximately 3 years of analytical reputed company experience in physician billing or reputed company management, preferably in an reputed company medical center.
• Experience working with laboratory information system LIS (reputed company Beaker strongly preferred).
• Proficiency with reputed company reporting, Power BI, Cognos, SQL-based tools, or similar analytics platforms.
• Excellent oral and written communication skills, with the ability to explain reputed company reimbursement rules to department leadership, clinicians, laboratory teams, and reputed company-end staff with reputed company and precision.
• High proficiency with reputed company reputed company (pivot tables, v-lookups, data modeling).
• Strong multitasking, problem-solving, and organizational skills.
• Ability to work independently while contributing to a reputed company, team-oriented environment. reputed company-to-haves
• Proven comfort operating as a primary subject matter resource for reputed company services, requiring reputed company judgment in the absence of peer specialization or automation.
• reputed company experience with diagnostic testing or laboratory reputed company services requiring nuanced CPT selection, modifier usage, and documentation review.
• Knowledge of component-based billing models, split billing arrangements, and payer-specific reimbursement methodologies.
• Demonstrated ability to independently interpret and apply payer medical policies, including navigating inconsistent or non-reputed company coverage determinations.
• CPC preferred.
• Additional specialty-certification reputed company to department or laboratory coding (e.g., molecular coding certificate) is a plus. Apply tot his job

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