Underpayment Denials Analyst

Job Summary

A company is looking for an Underpayment Denials Analyst to review managed care contracts, analyze healthcare claims, and build relationships with clients and payors.

Key Responsibilities:

• Research and evaluate denied claims, reviewing payor policies, clinical abstracts, and studies
• Analyze managed care contracts and healthcare claims to identify underpayments
• Contact insurance companies to resolve denials, obtain missing information, and arrange for payment or adjustment processing

Qualifications:

• Minimum 2 years of denial management and/or utilization review experience
• Experience reviewing and analyzing hospital claims
• Knowledge of healthcare codes including CPT, ICD-9, HCPC, DRG
• High school diploma or equivalent
• Moderate computer proficiency