Recovery Analyst – Underpayments
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Underpayment Recovery Analyst responsible for reviewing and resolving hospital claims. Join a tech-enabled company improving healthcare access and reimbursement through collaboration.
Responsibilities:
- Review, identify, and resolve underpaid hospital claims.
- Conduct detailed analyses of claim-level payments, follow up with payers, and prepare appeals for underpayments.
- Initiate rebilled or corrected claims and manage timely 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 as needed.
- Interpret complex hospital managed care contracts and validate expected reimbursements across multiple payer types.
- Document systemic payer issues and trends affecting reimbursement, recommending process improvements as needed.
- Meet or exceed established internal Key Performance Indicators (KPIs) related to claims reviewed and recovery accuracy.
Requirements:
- 3–5 years of 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 (e.g., DRG, APC, percent-of-charge, per diem).
- Experience with contract modeling tools and hospital billing systems (e.g., Epic, Cerner, Meditech).
- Knowledge of payer-specific policies, billing regulations, and denial types (technical and clinical), payer-specific portals and dispute resolution processes.
- Knowledge of CMS, Medicare Advantage, and state Medicaid plan rules.
- Strong analytical skills with the ability to interpret complex data and identify trends or discrepancies.
- Excellent written and verbal communication skills
- Proficient in Microsoft Excel and other data analysis/reporting tools.
Benefits:
- Competitive salaries
- Highly valued health insurance
- 401(k) plan with employer match
- Paid parental leave
Similar Jobs
Portfolio Analyst
Portfolio Analyst driving analytics and insights at Connexus Credit Union. Focus on credit risk and portfolio performance to optimize loan performance and risk governance.
Compensation and Benefits Analyst
Compensation and Benefits Analyst managing HR operations and compliance processes. Supporting benefits, retirement plans, and compensation data integrity for Connexus Credit Union.
FIU Analyst – Detection
FIU Analyst managing fraud investigations at SouthState Bank. Analyzing fraud alerts and collaborating with cross-department teams to mitigate risk.
Junior Product Analyst – Projects and Construction
Junior Product Analyst at Construmarket supporting product development and collaboration with stakeholders. Involves requirement gathering and ensuring delivery of user-focused solutions.
Senior OSB Integration Analyst
Analista de integração em tecnologia no Grupo SysMap, atuando com Oracle RIB e OSB. Suporte e desenvolvimento de integrações em ambientes complexos.
Senior Quality Analyst – Adobe Solutions
Quality Analyst focusing on Adobe solutions at SysMap, implementing strategies and mentoring junior QA professionals.
Demand Analyst
Demand Analyst focused on inventory management for veterinary hospitals and vendor collaboration. Utilizing analytical skills to improve supply chain efficiency in a pet health company.
Revenue Integrity Analyst
Revenue Integrity Analyst responsible for charge capture, compliance and process optimization in a healthcare setting. Collaborating with departments to enhance billing accuracy and reduce waste in revenue cycles.
Associate Revenue Cycle Analyst – Prior Authorizations
Associate Revenue Cycle Analyst responsible for ensuring data integrity and operational excellence in Prior Authorizations at Natera, a leader in genetic testing.
Analista de Onboarding e Customer Success
Analista de Onboarding e CS na VECTOR, atuando na execução e suporte de projetos logísticos estratégicos. Garantindo que os projetos sejam implantados com sucesso e dentro do que foi acordado.
Senior Analyst, Workforce Strategy and Planning
Senior Analyst managing TA capacity planning at DoorDash. Overseeing forecasting, funnel performance, and resource linkages across teams.
Third Party Liability Analyst
Third-Party Liability Analyst providing cost savings and insurance coverage determination for healthcare at Gainwell Technologies. Focusing on cost avoidance and recovery opportunities to enhance efficiency.
Junior Identity Analyst
Junior Identity Consultant implementing identity management systems at large clients. Involves meetings to define identity flows and verify integration effectiveness.
Ongoing Analyst – CyberArk
Participate in IAM deployments covering requirements, configuration, testing (UAT) and ongoing support while developing custom integrations and scripts. Monitor tickets, ensure SLA compliance, escalate high-impact incidents, and maintain technical documentation.
Mid-level Ongoing Analyst
Analista de Ongoing Pleno focado na plataforma Sailpoint integrando o time de Segurança da Informação. Gestão do ciclo de vida de identidades e automação de processos.
Identity Analyst – Mid-level
Analyst focusing on identity management using Sailpoint for Information Security team. Responsible for managing identity lifecycle and ensuring access governance.
Senior Research & Insights Analyst
Sr. Analyst role at Salesforce analyzing data to uncover trends and insights. Transforming research findings into compelling visualizations supporting strategic business decisions.
Quality Review & Audit Analyst
Quality Review & Audit Analyst evaluating complex medical conditions and compliance documentation at Cigna. Collaborating with team members to ensure data accuracy and suggest process improvements.
Senior Quality Analyst
Quality Analyst responsible for creating extensive testing plans to ensure functional coverage. Collaborating with the development team to identify and document bugs and automate tests.
Analista PMO Senior
Project Manager overseeing technology projects and agile processes at Grupo SysMap. Collaborating with teams to maintain schedules and quality targets throughout project life cycles.