Recovery Analyst – Underpayments
Trend Health Partners
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $50,000 - $75,000 per year
Job Level
Mid-LevelSenior
About the role
- 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.
Requirements
- 3–5 years of experience in healthcare revenue cycle, with a strong focus on underpayment/zero balance review, and payer reimbursement analysis.
- Understanding of hospital managed care contracts and reimbursement methodologies (e.g., DRG, APC, percent-of-charge, per diem).
- Experience with contract modeling tools and hospital billing systems (e.g., Epic, Cerner, Meditech).
- Knowledge of payer-specific policies, billing regulations, and denial types (technical and clinical), payer-specific portals and dispute resolution processes.
- Knowledge of CMS, Medicare Advantage, and state Medicaid plan rules.
- Strong analytical skills with the ability to interpret complex data and identify trends or discrepancies.
- Excellent written and verbal communication skills
- Proficient in Microsoft Excel and other data analysis/reporting tools.
Benefits
- Competitive salaries
- Highly valued health insurance
- 401(k) plan with employer match
- Paid parental leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
underpayment reviewpayer reimbursement analysishospital managed care contractsreimbursement methodologiescontract modeling toolshospital billing systemsdata analysisreporting toolsclaims managementappeals preparation
Soft skills
analytical skillscommunication skillsproblem-solvingattention to detailorganizational skills