Triage Analyst – Zero Balance

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $25 - $32 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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Aspirion

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2006

💼 Consulting

📦 Logistics

🛡️ Insurance

💰 Series unknown on 2012-02

Consulting • Logistics • Insurance

Aspirion is a healthcare revenue cycle management company that helps hospitals recover revenue from denied and complex claims. The company deploys AI automation and a proprietary Compass platform, staffed with US-based attorneys, clinicians, and AI engineers, to overturn clinical denials, maximize out-of-network reimbursement, perform zero-balance reviews, and recover payment variances across services such as denials management, AR management, complex claims, motor vehicle accidents, workers' compensation, TRICARE, and out-of-state Medicaid. Aspirion emphasizes measurable recovery impact (over $6 billion captured), increased collections for clients, HITRUST certification, Best in KLAS awards, and partnerships with large health systems.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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