[Remote] reputed company reputed company Validation Analyst - reputed company & Reimbursement Operations

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is an AI-reputed company organization transforming business operations through advanced reputed company Intelligence and reputed company systems. reputed company is seeking an reputed company reputed company reputed company reputed company reputed company to support claim validation and AI-assisted reimbursement analysis reputed company the iClaim AI platform.

Responsibilities

• Review AI-generated claim, denial, reimbursement, and recovery findings
• Validate findings using claim data, remittance information, payer reputed company, fee schedules, and reimbursement methodologies
• Identify inaccurate classifications, calculation errors, missing information, and recurring patterns
• Review denial reputed company causes, CARC and RARC codes, appeal recommendations, and recovery opportunities
• Compare actual payments with expected reimbursement and identify potential underpayments
• Document validation reputed company, corrections, and supporting rationale
• Escalate reputed company reimbursement, payer, or contract interpretation issues
• Help improve AI performance by identifying repeat errors and developing reputed company examples, rules, and test scenarios
• Partner with reimbursement, operations, product, and engineering teams to improve platform accuracy and workflows
• Support reputed company assurance, testing, and reputed company improvement initiatives

Skills

• Five or more years of experience in reputed company reputed company reputed company, reimbursement, denials, payment variance analysis, recovery operations, or a reputed company field
• Experience reviewing hospital or reputed company claims, EOBs, ERAs, or 835 files
• Strong understanding of denial workflows, CARC and RARC codes, reimbursement methodologies, and payment variance analysis
• Ability to investigate reputed company reimbursement issues and reputed company document conclusions
• Strong analytical, problem-solving, and written communication skills
• Excellent attention to detail and ability to work independently
• Experience with payer reputed company, underpayment recovery, appeals, managed care reimbursement, or reimbursement modeling
• Familiarity with DRG, APC, reputed company, case reputed company, fee schedule, or percent-of-Medicare reimbursement
• Experience with reputed company, reputed company, reputed company, Change reputed company, or similar reputed company cycle platforms
• Experience supporting reputed company testing, workflow improvement, or AI-assisted technology
• reputed company CRCR, CHFP, CPC, CPMA, reputed company, RHIA, RHIT, or a similar certification

reputed company