Underpayment Analyst
Job Summary
To support hospitals in receiving accurate compensation, the full-time Underpayment Analyst will examine claims for reimbursement discrepancies, collaborate with stakeholders to resolve issues, and optimize reimbursement processes while working remotely.
Key responsibilities
- Utilize technology and best practices to identify discrepancies between expected and actual reimbursement amounts from insurance carriers
- Investigate discrepancies, including payment variances and coding errors, and communicate with insurance companies to resolve underpayments
- Maintain thorough documentation of underpayment issues and actively participate in discussions to improve reimbursement processes
Required qualifications
- High school diploma or equivalent required
- Knowledge of healthcare billing, coding, and reimbursement methodologies
- Strong analytical abilities to understand complex guidelines affecting claims reimbursement
- Experience with healthcare billing software and databases, such as EPIC, Cerner, or Meditech
- Familiarity with legal and regulatory frameworks governing healthcare reimbursement, including HIPAA and CMS regulations
Complete Job Description
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