Payment Variance Analyst

🔥 6 hours ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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Med-Metrix

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2010

🏥 Healthcare

☁️ SaaS

💰 Private equity on 2025-09

Healthcare • SaaS

Med-Metrix is a company for which only a minimal web presence was provided (the page only displayed "Loading application... Your web browser must have JavaScript enabled... "). No product, market, or mission details were included in the supplied text. Based on the company name alone, it plausibly focuses on medical or clinical metrics, analytics, or healthcare software, but that is speculative and not confirmed by the provided information. Further public details would be required to be more specific.

📋 Description

• Identify opportunities to pursue additional reimbursement due to contractual payment discrepancies • Use managed care contracts to determine whether appropriate rates, provisions, and terms are being followed by payers • Report root causes of identified payment discrepancies to the manager • Perform payment variance analysis to identify trends in underpaid claims • Request and prepare payer-underpayment data in a uniform format for internal Payment Variance Specialists to validate • Analyze data and work with Analytics and/or Pricing teams to resolve contract-load variances and produce accurate reporting • Analyze client heat maps monthly for accuracy • Identify and report underpayments and denial trends to client leadership • Track resolution and collection of underpaid claims • Escalate issues with payers or managed care teams for collection and resolution • Provide support and guidance to Payment Variance Specialists on projects and support the team as needed • Initiate appeals when necessary • Track recurring underpayment patterns and systematic issues • Analyze, identify, and resolve issues causing payer payment delays, including billing and coding errors • Protect and disclose patients’ PHI in accordance with HIPAA standards • Comply with Information Security and HIPAA policies and procedures • Limit viewing of PHI to the minimum necessary to perform assigned duties • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent required • 2 years’ experience in Commercial insurance collections, including submitting and following up on claims • 2 years’ experience of underpayment analyst experience • Detailed knowledge of Managed Care reimbursement methodologies • Experience in Hospital/Facility billing • Ability to adapt to learning a wide range of systems and regulations • Proficiency in Microsoft Office Suite • Strong interpersonal skills and ability to communicate well at all levels of the organization • Strong problem solving and creative skills, with the ability to exercise sound judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability with a strong sense of urgency and results orientation • Excellent written and verbal communication skills required • Gracious and welcoming personality for customer service interaction • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes • Ability to follow directions, collaborate with others, and handle stress

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