Product Analyst
Cotiviti
Cloud
Provider Services Analyst I
Trend Health Partners
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $50,000 - $60,000 per year
Job Level
JuniorMid-Level
About the role
- TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Provider Services Analyst I’s primary responsibility is to determine denials from remittance /explanation of benefits, trend root cause, and take appropriate steps for resolution by crafting detailed appeal letters and contacting insurance payers for resolution. This individual must be self-motivated and be able to work independently and within a team structure. Ensures legal compliance by following guidelines, account contract, and the company's business plan.
Requirements
- Prior experience reviewing, processing, and recovering in patient or outpatient clinical/technical post-service denials preferred Multi-state Knowledge of payer requirements preferred but not required specifically in appeal guidelines and timeframes Knowledge of UB04s and Claim Adjustment Reason Codes (CARC) and Reason Adjustment Reason Codes (RARC) is preferred Ability to resolve claims by composing a compelling appeal letter; guiding resolution of non-routine claims; auditing claims with decision resulting in a high overturn rate. Prior experience navigating EMRs (Cerner, Epic, etc.) and patient financial systems Thought leader with critical eye for detail Strong ability to effectively multi-task Superior verbal, written, customer service, and analytical skills with resolution is preferable. A continuous drive to stay abreast of healthcare industry policies and regulations Understanding of medical terminology used in administrative and clinical documentation is preferable Familiarity with Microsoft Office products Possession of a High School Diploma with some college 2-5 years of experience within the healthcare market 2-5 years of experience in navigating EMR and Patient Financial related software support systems, EPIC and Cerner experience a plus Previous experience within an acute care or outpatient environment of revenue cycle
