Trend Health Partners

Analyst

• Assist providers in identifying, reviewing, and validating patient accounts in a credit balance state
• Manage accounts receivables to ensure timely collection of identified Client overpayments
• Prioritize workload to meet deadlines and goals using guidelines set out by manager
• Achieve individual productivity and quality standards
• Professionally and proactively build relationships and maintain contact with the appropriate personnel at Providers
• Respond to all provider and Client requests in a timely manner
• Escalate to manager any situation outside the employee’s control that could adversely impact the business relationship
• Always represent TREND and our clients in a professional manner
• Cooperate with team members to meet goals and complete tasks

Credit Balance Analyst I

• Review, identify, and resolve underpaid hospital claims.
• Conduct detailed analyses of claim-level payments, follow up with payers, and prepare appeals for underpayments.
• Initiate rebilled or corrected claims and manage timely follow-up on outstanding underpaid or denied claims.
• Prepare and submit detailed appeals with appropriate documentation and contract references.
• Track outcomes and escalate unresolved issues as needed.
• Interpret complex hospital managed care contracts and validate expected reimbursements across multiple payer types.
• Document systemic payer issues and trends affecting reimbursement, recommending process improvements as needed.
• Meet or exceed established internal Key Performance Indicators (KPIs) related to claims reviewed and recovery accuracy.

Credit Balance Analyst I

Recovery Analyst – Underpayments