Recovery Analyst – Underpayments
Trend Health Partners
full-time
Posted on:
Location Type: Remote
Location: United States
Visit company websiteExplore more
Salary
💰 $50,000 - $75,000 per year
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 & Tools
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