PP Senior Analyst

The PP Senior Analyst is responsible for ensuring the accurate, timely, and compliant posting of all payments, adjustments, and denials in the revenue cycle management process. This role involves handling high-dollar, aged, and complex payment cases while ensuring the reconciliation of accounts and maintaining accuracy in cash application.

The PP Senior Analyst serves as a subject matter expert, identifying payment posting discrepancies, resolving issues related to payer remittances, and supporting process optimization initiatives. Additionally, this role may assist in training and mentoring junior team members and collaborating across teams to enhance payment posting efficiency and accuracy.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• Post all insurance and patient payments, adjustments, and denials accurately into the client’s system.
• Handle complex and high-dollar remittance advice (ERAs and EOBs) from payers, ensuring correct allocation of payments.
• Research and resolve unapplied or misapplied payments, ensuring all balances are correctly reconciled.
• Perform quality audits on posted batches to verify accuracy and compliance with standard operating procedures (SOPs).
• Identify recurring posting issues or payment variances and escalate to supervisors or billing teams as required.
• Reconcile daily deposits and posted batches to ensure complete and accurate financial posting.
• Collaborate with AR and Billing teams to resolve missing remittances, partial payments, or payer discrepancies.
• Maintain detailed documentation for all posting activities to ensure a clear and auditable transaction history.
• Ensure compliance with HIPAA, payer regulations, and organizational policies.
• Support process improvements to enhance posting turnaround time and quality.
• Assist in the training and mentoring of junior analysts and new team members.

All activities must be performed in compliance with Equal Employment Opportunity (EEO) laws, HIPAA, ERISA, and other applicable regulations.

Key Result Areas (KRAs)

Category

Target

Weightage

Remarks

Production

≥ 100%

40.0%

High $ value claims, Aged & Complex claims

Quality

≥ 98.5%

40.0%

Achieve your set target on a monthly basis

Follow SOPs and Checklists

100%

8.0%

Follow SOPs, Site Books, and Checklists

Time on System

9 hrs daily

4.0%

Meet the required 9 hrs time-on-system mandate (only 3 days allowed for non-adherence per month)

Shift Adherence

Login before shift time

3.0%

Meet the required shift start/end time mandate (only 2 days allowed for non-adherence per month for full marks)

Initiatives

n

5.0%

• Offers help to Supervisor• Seeks learning through added responsibilities• Takes initiative to understand processes better

Minimum Requirements:

• Graduate (Bachelor’s degree or equivalent).
• Minimum 4–6 years of experience in U.S. healthcare payment posting, cash applications, or revenue cycle management.
• Strong understanding of payment posting processes, ERA/EOB interpretation, and reconciliation.
• Working knowledge of payer payment structures, adjustments, and denial codes.
• Strong communication and analytical skills.
• Willingness to work continuous night shifts and flexible schedules as required.

Education / Experience / Certification:

• Bachelor’s degree preferred (Finance, Accounting, Healthcare, or related field).
• Prior experience in U.S. healthcare BPO/RCM preferred.
• Experience working with EHR systems and clearinghouses (Waystar, Availity, Change Healthcare, etc.).
• Proficiency in MS Excel, Word, and Google Sheets.
• Certification in Medical Billing/Coding (optional but preferred).

Skills & Technical Proficiency:

• Advanced analytical and reconciliation skills with strong attention to detail.
• Expertise in interpreting payer remittances, adjustments, and denial codes.
• Strong organizational and multitasking abilities to handle large volumes accurately.
• Effective problem-solving and time management skills.
• Ability to work independently and mentor junior team members.
• High commitment to maintaining confidentiality and compliance with HIPAA and internal quality standards.

Working Environment/Physical Demands

Working Environment:

• General office environment: Works generally at a desk in a well-lighted, air-conditioned office, with moderate noise levels. 
• Periods of stress may occur.

Physical Demands:

• Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
• Some walking and standing relative to interaction with other personnel.

 

Travel Requirements:

    None       Occasional             Moderate          Frequent           Very Frequent

                            (25% or Less)                  (25% - 40%)               (40% - 80%)             (80% or m

Other possible Unofficial Titles

Unofficial titles may be given by the manager and used for email signature.

Note: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. This document does not create an employment contract, implied or otherwise.  It does not alter the "at will" employment relationship between the company and the employe

Individual Contributor