Underpayment Recovery Analyst

Job not on LinkedIn

🕒 April 1

🇺🇸 United States – Remote

💵 $50k - $65k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 55%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Trend Health Partners

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

🏥 Healthcare

⚕️ Healthcare Insurance

💳 Fintech

💰 Private Equity Round on 2023-01

Healthcare • Healthcare Insurance • Fintech

Trend Health Partners is a healthcare technology company focused on enhancing payer-provider collaboration to improve financial management in healthcare. By leveraging AI-enabled technology, Trend Health Partners offers solutions to reduce credit balances, minimize payment denials, and ensure payment accuracy, ultimately fostering better relationships among stakeholders in the healthcare ecosystem. With a commitment to neutrality and efficiency, they aim to reshape the healthcare financial landscape for the benefit of providers, payers, and patients alike.

📋 Description

• Perform detailed analysis of remittances, explanations of benefits (EOBs), payer correspondence, and account detail to identify underpayments or incorrect claim adjudications • Evaluate claim payment variances against expected reimbursements based on client-specific contract terms • Identify and categorize underpayment types and root causes, including pricing discrepancies, DRG/APC miscalculations, bundling errors, and inappropriate denials • Initiate rebilled or corrected claims and follow up on outstanding underpaid or denied claims • Prepare and submit detailed appeals with appropriate documentation and contract references • Track outcomes and escalate unresolved issues • Interpret hospital managed care contracts, fee schedules, payer policies, and government payer reimbursement policies • Validate expected reimbursement across Medicare Advantage, Medicaid, and Commercial payers • Identify and document systemic payer issues and reimbursement trends • Partner with internal teams and client stakeholders to recommend process improvements, payer escalations, or system configuration changes • Meet or exceed KPIs related to claims reviewed, identifications, recovery amounts, appeal turnaround times, and accuracy • Maintain organized case documentation in internal systems and client-facing portals • Perform other duties as assigned

🎯 Requirements

• Experience in healthcare revenue cycle, with a strong focus on underpayment/zero balance review and payer reimbursement analysis • Understanding of hospital managed care contracts and reimbursement methodologies, including DRG, APC, percent-of-charge, and per diem • Experience with contract modeling tools and hospital billing systems such as Epic, Cerner, and Meditech • Knowledge of payer-specific policies, billing regulations, denial types, payer-specific portals, and dispute resolution processes • Knowledge of CMS, Medicare Advantage, and state Medicaid plan rules • Strong analytical skills to interpret complex data and identify trends or discrepancies • Excellent written and verbal communication skills • Proficiency in Microsoft Excel and other data analysis/reporting tools • Ability to work primarily in an indoor office environment with computers and printers • Ability to perform sedentary work, typing, and repetitive computer-related motions throughout the day • Ability to concentrate on analytical tasks, read information, and communicate verbally and in writing throughout the day • May be required to complete background and drug screenings and disclose personal health information or personally identifiable information, subject to applicable accommodations and legal requirements

🏖️ Benefits

• Competitive salaries • Health insurance • 401(k) plan with employer match • Paid parental leave • Collaborative and innovative work environment

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