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Revenue Cycle Claims Analyst Jobs in Puerto Rico

PeopleLift

Junior Accountant

San Juan, PR · On-site

$46K - $58K/yr

Compilation of data used in financial statements, variance analyses, and management reporting ... Basic familiarity with healthcare revenue cycle concepts or third-party payor billing. * Strong ...

Sonnedix Solar Puerto Rico LLC

Asset Manager

San Juan, PR · On-site

$90 - $120/hr

The Asset Manager sustains and optimizes the performance of the assets over their entire life cycle ... Manage and maintain all required insurance policies and process claims. * Ensure compliance with ...

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Medimpact

Account Executive II

San Juan, PR · On-site

$102.26 - $178.96/hr

... revenue, and product goals as identified in client strategic plans.**Essential Duties and ... Influence client decisions through analytic reports, industry trends, and other facts that ...

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Revenue Cycle Claims Analyst information

What is a revenue cycle claims analyst?

A Revenue Cycle Claims Analyst is a professional who reviews, analyzes, and manages healthcare claims to ensure accurate billing and timely reimbursement from insurance companies. They identify and correct errors in claims submissions, work to resolve denials, and help optimize the revenue cycle process for healthcare providers. Their work is vital for maintaining the financial health of healthcare organizations by ensuring that all services rendered are properly billed and paid. Additionally, they may collaborate with billing teams, coders, and insurance representatives to address discrepancies and improve claim approval rates.

What are some common challenges a revenue cycle claims analyst faces when working with denied claims, and how can these be addressed?

A Revenue Cycle Claims Analyst often encounters challenges such as deciphering complex denial codes, managing high claim volumes, and communicating effectively with payers to resolve issues. Addressing these challenges requires strong attention to detail, persistence in following up on outstanding claims, and staying updated on payer policies and regulations. Collaborating closely with billing teams and leveraging analytical tools can help streamline the appeals process and reduce future denials.

What are the key skills and qualifications needed to thrive as a revenue cycle claims analyst, and why are they important?

To thrive as a Revenue Cycle Claims Analyst, you need strong analytical skills, attention to detail, and a solid understanding of healthcare billing and insurance processes, often supported by a degree in healthcare administration or a related field. Familiarity with claims management software, electronic health record (EHR) systems, and knowledge of coding standards like ICD-10 and CPT are typically required. Excellent problem-solving skills, effective communication, and the ability to manage multiple tasks efficiently are standout soft skills for this role. These competencies are crucial for accurately processing claims, reducing denials, and ensuring timely reimbursement for healthcare organizations.

What is the difference between Revenue Cycle Claims Analyst vs Medical Billing Specialist?

AspectRevenue Cycle Claims AnalystMedical Billing Specialist
CredentialsCertification in medical billing or coding, knowledge of insurance policiesCertification often preferred, similar credentials
Work EnvironmentHealthcare facilities, insurance companies, revenue cycle departmentsMedical offices, billing companies, healthcare providers
Job FocusAnalyzing claims, resolving denials, optimizing revenue cycleSubmitting claims, coding, payment posting

The Revenue Cycle Claims Analyst and Medical Billing Specialist roles both involve billing and coding, but the analyst focuses more on analyzing claims data and resolving issues to improve revenue, while the specialist handles the day-to-day submission and processing of claims. Both roles require similar credentials and work in healthcare settings, but their primary responsibilities differ in scope and focus.

What job categories do people searching Revenue Cycle Claims Analyst jobs in Puerto Rico look for?

The top searched job categories for Revenue Cycle Claims Analyst jobs in Puerto Rico are:

What cities in Puerto Rico are hiring for Revenue Cycle Claims Analyst jobs?

Cities in Puerto Rico with the most Revenue Cycle Claims Analyst job openings:

Revenue Cycle Claims Analyst jobs near you
Infographic showing various Revenue Cycle Claims Analyst job openings in Puerto Rico as of August 2026, with employment types broken down into 92% Full Time, 5% Part Time, and 3% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Supervisory Internal Revenue Agent (Temporary Not To Exceed, May Be Extended Up To 5 Years)

Criminal Investigation & Law Enforcement | IRS Careers

Mayaguez, PR • On-site

$125K/yr

Full-time, Temporary

Posted 9 days ago

Key responsibilities

  • Review and analyze financial records, taxpayer accounts, and supporting documentation to determine the correctness of tax treatments and proposed adjustments.

  • Develop examination strategies, coordinate issue development, and assign priorities to ensure consistent application of Internal Revenue laws and regulations.

  • Research and interpret Internal Revenue Code provisions, Treasury Regulations, court decisions, and other guidance to resolve technical examination issues.

Internal Revenue Service rating

7.4

Company rating: 7.4 out of 10

Based on 130 frontline employees who took The Breakroom Quiz

159th of 297 rated public sector bodies

Job description


WHAT IS LARGE BUSINESS & INTERNATIONAL DIVISION?
A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisions
  • Position(s) are to be filled in following area(s):
    • LBI - ADCCI - Compliance Planning & Analytics (CP&A), Workload Development & Delivery (WDD), Whistleblowers Team.

REVIEW THE ADDITIONAL INFORMATION BELOW FOR FURTHER DETAILSQualifications:

Federal experience is not required. Experience may have been gained in the public sector, private sector or through Volunteer Service. One year of experience refers to full-time work; part-timework is considered on a prorated basis. To ensure full credit for your work experience, please indicate dates of employment by month/day/year, and indicate number of hours worked per week, on your resume.
You must meet the following requirements by the closing date of this announcement.
BASIC REQUIREMENTS All GRADES: A Certificate as a Certified Public Accountant (CPA) or a bachelor's or higher degree in accounting that included at least 30 semester hours in accounting or 24 semester hours in accounting and an additional 6 semester hours in related subjects such as business law, economics, statistical/quantitative methods, computerized accounting, or financial systems, financial management, or finance.
OR
A bachelor's or higher degree in a field other than accounting or a combination of education and experience equivalent to 4 years that included at least 30 semester hours in accounting or 24 semester hours in accounting and 6 semester hours in related subjects as described above.
AND
SPECIALIZED EXPERIENCE IR-04: In addition to basic requirements, to be minimally qualified for this position you must have one (1) year of specialized experience at a level of difficulty and responsibility equivalent to the next lower level within the payband or GS grade in the normal line of progression in the Federal service that demonstrates the required managerial skills and technical competence required to perform the job. To be qualifying for this position your experience must include:

  • Qualifying experience must have been in progressively responsible and diversified professional accounting or auditing work that required 1) knowledge of and skill in applying professional accounting principles, theory, and practices to analyze and interpret accounting books, records, or systems specifically to determine their effect on Federal tax liabilities and their adequacy for recording transactions affecting tax liabilities; 2) skill in interpreting and applying Federal tax law for individuals, business, and/or exempt organizations, partnerships, and corporations; 3) knowledge of business and trade practices to develop tax issues based on analysis and evaluation of overall business operations and financial condition; 4) knowledge of corporate financial transactions and financial management principles and practices; and 5) skill in interacting effectively with a broad range of individuals and in negotiating with specialists in accounting, legal, tax, and other similar business-related professions.
  • Experience directing technical examination activities by establishing examination strategies, coordinating issue development, assigning technical priorities, workload selection criteria, and ensuring consistent application of Internal Revenue laws, regulations, rulings, and procedures.
  • Experience reviewing examination findings, financial records, accounting data, taxpayer accounts and transcripts, technical analyses, workpapers, and supporting documentation to determine whether proposed tax treatments, adjustments, and examination conclusions are supported by factual information and applicable tax authorities.
  • Experience evaluating examination and compliance issues involving corporate returns, partnerships, pass-through entities, or other complex business transactions by analyzing financial data, transaction documentation, supporting evidence, and applicable Federal tax authorities.
  • Experience researching, interpreting, and applying Internal Revenue Code provisions, Treasury Regulations, court decisions, revenue rulings, revenue procedures, and other published guidance to resolve technical examination issues and determine tax treatment.
  • Experience developing examination approaches for tax compliance issues including emerging and reportable transaction issues by identifying areas of audit risk, establishing issue-development priorities, and coordinating technical issue resolution throughout the examination and selection process.
  • Experience coordinating examination activities with Counsel, Appeals, Technical Advisors, economists, engineers, valuation specialists, international specialists, or other subject-matter experts to resolve technical tax issues.
  • Experience developing or reviewing technical recommendations, examination and claims determinations, reports, memoranda, work papers, or issue analyses that document examination findings, supporting legal authorities, and proposed tax adjustments.

AND
You must also meet the following requirement(s):

  • TIME AFTER COMPETITIVE APPOINTMENT (TACA): By the closing date (or if this is an open continuous announcement, by the cut-off date) specified in this job announcement, current civilian employees must have completed at least 90 days of federal civilian service since their latest non-temporary appointment from a competitive referral certificate, known as time after competitive appointment. For this requirement, a competitive appointment is one where you applied to and were appointed from an announcement open to "All US Citizens"

For more information on qualifications please refer to OPM's Qualifications Standards.
Go to Understanding the IRS Paybands for GS/IR conversion.

Education:A college or university degree generally must be from an accredited (or pre-accredited) college or university recognized by the U.S. Department of Education. For a list of schools which meet these criteria, please refer to Department of Education Accreditation page.
FOREIGN EDUCATION: Education completed in foreign colleges or universities may be used to meet the requirements. You must show proof the education credentials have been deemed to be at least equivalent to that gained in conventional U.S. education program. It is your responsibility to provide such evidence when applying. Click here (Section 3, Explanation of Terms) or here for Foreign Education Credentialing instructions.
We recommend choosing an evaluator from a member organization of one of the following national associations of credential evaluation services: National Association of Credential Evaluation Services (NACES) or Association of International Credentials Evaluators (AICE).Employment Type: OTHER

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