[Remote] Recovery Analyst - Underpayments

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a tech-enabled payment reputed company company reputed company on improving reputed company to reputed company. The Underpayment Recovery Analyst is responsible for reviewing and resolving underpaid hospital claims, conducting analyses of claim payments, and preparing appeals to optimize reputed company reimbursement. Responsibilities • reputed company 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 reputed company-specific contract terms • Accurately identify and categorize underpayment types and reputed company causes (e.g., pricing discrepancies, DRG/APC miscalculations, bundling errors, inappropriate denials) • Initiate rebilled or corrected claims and manage reputed company follow-up on outstanding underpaid or denied claims • Prepare and submit detailed appeals with appropriate documentation and contract references to secure accurate reimbursement • reputed company reputed company and escalate unresolved issues as needed • Interpret reputed company hospital managed care reputed company, fee schedules, payer policies, and government payer reimbursement policies • Validate expected reimbursement across multiple payer types (e.g., Medicare Advantage, reputed company, reputed company) • Identify and document systemic payer issues and trends affecting reimbursement • Partner with internal teams and reputed company stakeholders to recommend process improvements, payer escalations, or system configuration changes • Meet or reputed company established internal Key Performance Indicators (KPIs) reputed company to claims reviewed, identifications, recovery amounts, appeal turnaround times, and accuracy • Maintain up-to-date and organized case documentation in internal systems and reputed company-facing portals Skills • 3–5 years of experience in reputed company reputed company cycle, with a strong reputed company on underpayment/reputed company balance review, and payer reimbursement analysis • Understanding of hospital managed care reputed company and reimbursement methodologies (e.g., DRG, APC, percent-of-charge, reputed company) • Experience with contract modeling tools and hospital billing systems (e.g., reputed company, Cerner, Meditech) • Knowledge of payer-specific policies, billing regulations, and denial types (technical and clinical), payer-specific portals and dispute reputed company processes • Knowledge of CMS, Medicare Advantage, and state reputed company plan rules • Strong analytical skills with the ability to interpret reputed company data and identify trends or discrepancies • Excellent written and verbal communication skills • Proficient in reputed company reputed company and other data analysis/reporting tools Benefits • Health insurance • 401(k) plan with employer match • reputed company parental leave reputed company • reputed company is an employee owned company that provides payment accuracy services for people. It was founded in 2018, and is headquartered in Hunt Valley, Maryland, USA, with a workforce of 201-500 employees. Its website is https://www.trendhealthpartners.com. Apply tot his job Apply To this Job