Triage Analyst – Zero Balance

🕒 Ontem

🏄 California – Remoto

🏄 California – Remote

💵 $25 - $32 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🧐 Analista

👻 Score fantasma 0%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

Candidatar-se

Encontrar Vagas Remotas Similares

Configurar Alerta de Email para Novas Vagas

📊 Verifique sua pontuação de currículo para esta vaga

Melhore suas chances de conseguir uma entrevista verificando sua pontuação de currículo antes de se candidatar.

Enviar Currículo

Aspirion

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2006

💼 Consultoria

📦 Logística

🛡️ Seguros

💰 Series unknown em 2012-02

Consulting • Logistics • Insurance

Aspirion é uma empresa de gestão de ciclo de receita na área da saúde que auxilia hospitais a recuperar receitas de reivindicações negadas e complexas. A empresa emprega automação por IA e uma plataforma proprietária chamada Compass, composta por advogados, clínicos e engenheiros de IA, todos baseados nos EUA, para reverter negações clínicas, maximizar reembolsos fora da rede, realizar revisões de saldo zero e recuperar variações de pagamento em serviços como gestão de negações, gestão de contas a receber (AR), reivindicações complexas, acidentes de trânsito, compensação de trabalhadores, TRICARE e Medicaid de fora do estado. A Aspirion enfatiza o impacto mensurável de recuperação (mais de $6 bilhões capturados), aumento de coleções para os clientes, certificação HITRUST, prêmios Best in KLAS e parcerias com grandes sistemas de saúde.

Descrição

• Review and interpret hospital contracts with insurance carriers, model claims data, and identify reimbursement discrepancies and revenue recovery opportunities • Research and monitor federal, state, and payer-specific regulations related to hospital reimbursement methodologies • Collaborate with technical teams to develop and implement audit flags identifying emerging underpayment trends • Analyze large and complex healthcare claims data sets for underpayment, denial, and reimbursement variance trends • Evaluate contract modeling results and validate payment variances using claim-level data • Determine scope, recoverability, and appropriateness for zero-balance audit review • Identify, analyze, and communicate underpayment trends and revenue recovery opportunities • Partner with Customer Success and Client Performance teams to route appropriate claims through the recovery pipeline • Provide revenue intelligence and operational insights supporting client performance, reimbursement optimization, and strategic decision-making • Identify underpayment and denial root causes and assign appropriate denial categories • Review payer portals, client systems, provider notes, EOBs, remittance advice, and other documentation to understand account history and claim status • Communicate with insurance carriers and internal stakeholders to clarify claim status and support comprehensive appeal submissions • Maintain accurate documentation of denial actions, findings, and escalation activities • Prioritize denials based on financial impact, aging, contractual requirements, and appeal deadlines • Route denied claims to appropriate resolution pathways based on denial type, payer requirements, and documentation • Adapt to new technologies, software platforms, automation tools, reporting systems, and process enhancements • Ensure compliance with payer guidelines, regulatory requirements, organizational policies, and HIPAA • Work independently and collaboratively to achieve productivity and quality goals

🎯 Requisitos

• High school diploma or equivalent required • Strong analytical and critical thinking skills with the ability to evaluate denial root causes • Strong written and verbal communication skills • Ability to multi-task and manage competing priorities • Proven ability to learn and adopt new technologies, software applications, and operational processes quickly • Ability to research and interpret insurance information and benefits • Strong attention to detail and accuracy in documentation • Ability to work independently in a fast-paced environment • Reliable attendance and consistent performance • Bachelor’s degree preferred or equivalent combination of education and experience • Prior experience in healthcare revenue cycle or denial management environments • Experience with denial analytics platforms and payer portal navigation • Experience in identifying denial root causes and applying critical thinking to support accurate triage and routing • Familiarity with insurance carriers and payer guidelines • Demonstrated ability to identify trends and process improvement opportunities • Experience working in a productivity and quality metrics-driven environment • Remote work experience in a structured environment • Experience working with EMR systems such as Epic or similar platforms • Ability to comply with HIPAA, GLBA, FCRA, and other applicable laws and organizational policies • US remote-based colleagues must not work outside the United States without prior written approval

🏖️ Benefícios

• Fully remote position • Flexibility and personal and professional growth opportunities • Opportunity to engage with innovative technology • Collaboration with a diverse and talented team • Self-development and continuous feedback and learning opportunities