Underpayment Analyst, Denials - Zero Balance
New
REMOTEFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 5+ years’ experience in healthcare field working in billing or collections
- Required Skills
- Microsoft ExcelMS Office
Requirements
- High School Diploma or GED; Associates or Bachelor’s Degree preferred.
- 5+ years’ experience in healthcare billing or collections.
- 1+ years’ client-facing or customer service experience.
- Intermediate understanding of insurance payer/provider claims processing.
- Intermediate knowledge of ICD, HCPCS/CPT coding and medical terminology.
- Strong understanding of the revenue cycle process and hospital reimbursement.
- Intermediate knowledge of Managed Care contracts, contract language, and regulatory requirements.
- Familiarity with HMO, PPO, IPA, and capitation models.
- Strong proficiency in MS Office (Word, Excel, Outlook).
- Ability to work independently as a self-starter.
- Proven analytical and problem-solving skills.
Responsibilities
- Review, evaluate, appeal, and follow up on outstanding, denied, underpaid, and assigned claims using proprietary systems.
- Analyze payment documentation and medical provider contracts to determine correct reimbursement.
- Identify and collect cash payments from insurance companies by reviewing hospital contracts.
- Research and acquire medical records to support complex underpayment appeals.
- Conduct telephone follow-up with payers to ensure claims receipt and facilitate resolution of outstanding receivables.
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