Managed Care Appeals Analyst

Job Summary

A company is looking for a Managed Care Appeals Analyst to handle underpayment appeals and ensure accurate reimbursement from payors.

Key Responsibilities

• Research closed $0 balance accounts for underpayment amounts and ensure accurate contractual reimbursements
• Create detailed appeals for unpaid services, including supporting documentation from payor contracts
• Monitor and document payment accuracy, resolving outstanding amounts and recoupments as necessary

Qualifications and Requirements

• Associate or bachelor's degree in Accounting, Finance, Business Administration, Healthcare Administration, or related field, or equivalent work experience
• Minimum of one year of healthcare-related experience in auditing
• 4+ years of experience in revenue cycle, hospital reimbursement, and appeals writing
• Proficiency in reimbursement methodologies and analyzing claims data
• Intermediate skills in Microsoft applications and basic understanding of HIT systems