Contractual Claims Analyst

Job Summary

To support the revenue cycle operations, the remote Contractual Claims Analyst will manage the review, analysis, and resolution of medical claims, focusing on contractual reimbursement accuracy, underpayments, and payment variances.

Key responsibilities

• Proactively review and resolve accounts involving contractual underpayments and payment discrepancies
• Analyze payer contracts and reimbursement methodologies to determine expected reimbursement and identify variances
• Prepare and submit payer disputes and appeals, ensuring appropriate documentation and follow-up for recovery efforts

Required qualifications

• High school diploma or equivalent; associate or bachelor's degree in a related field preferred
• Minimum of 2 years of experience in healthcare revenue cycle or reimbursement analysis
• Demonstrated experience in resolving underpaid or incorrectly reimbursed healthcare claims
• Working knowledge of healthcare reimbursement methodologies and payer practices
• Intermediate skills in Microsoft Office, particularly Excel, Word, and Outlook