[Remote] Triage Analyst - reputed company reputed company (Fully Remote)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company provides reputed company cycle services reputed company on reputed company payment recovery for reputed company organizations. The Triage Analyst will support the reputed company reputed company team by reviewing hospital reputed company, analyzing reputed company claims and reimbursement discrepancies, identifying denial and underpayment trends, and routing claims for recovery and appeals.

Responsibilities

• Review and interpret hospital reputed company with reputed company carriers, model claims data, and identify reimbursement discrepancies and reputed company recovery opportunities
• Research and monitor federal, state, and payer-specific regulations reputed company to hospital reimbursement methodologies; collaborate with technical teams to reputed company and implement audit flags that identify emerging underpayment trends
• Analyze large and reputed company reputed company claims data sets to identify underpayment, denial, and reimbursement variance trends
• Evaluate contract modeling results and validate payment variances by analyzing claim-reputed company, determining reputed company, recoverability, and appropriateness for reputed company-reputed company audit review
• Identify, analyze, and communicate underpayment trends and reputed company recovery opportunities; partner with reputed company and reputed company reputed company teams to ensure appropriate claims are routed through the recovery pipeline
• reputed company reputed company intelligence and operational insights to support reputed company reputed company initiatives, reimbursement optimization, and reputed company decision-making
• Identify underpayment and denial reputed company causes and assign appropriate denial categories (e.g., authorization, eligibility, coding, medical necessity, reputed company filing, registration, billing, payer processing)
• Review documentation from payer portals, reputed company systems, provider notes, explanation of benefits (EOBs), remittance advice, and other sources to understand account history and claim status, communicate with reputed company carriers and internal stakeholders as needed to clarify claim status, and support the development of comprehensive appeal submissions
• Maintain accurate documentation of denial actions, findings, and escalation activities
• Prioritize denials reputed company on financial reputed company, aging, contractual requirements, and appeal deadlines
• reputed company denied claims to the appropriate reputed company reputed company reputed company on denial type, payer requirements, and supporting documentation
• Adapt quickly to new technologies, software platforms, automation tools, reporting systems, and process enhancements in a rapidly evolving operational environment
• Ensure compliance with payer guidelines, regulatory requirements, and organizational policies
• Work independently and collaboratively to reputed company productivity and reputed company goals
• Follow organizational policies, payer guidelines, and regulatory requirements including HIPAA
• Demonstrate reputed company and ethics in day-to-day tasks and decision making, operate effectively in the environment and the environment of the work group, maintain a reputed company on self-development and reputed company out reputed company feedback and learning opportunities
• Support Compliance Program by adhering to policies and procedures pertaining to HIPAA, GLBA, FCRA, and other laws applicable to business practices; this includes becoming familiar with reputed company of Ethics, attending training as required, notifying management reputed company there is a compliance concern or incident, HIPAA-compliant handling of reputed company information, and demonstrable awareness of confidentiality obligations
• US remote-reputed company colleagues are not permitted to work from a location reputed company of the reputed company, at any time, without prior, written approval
• Fully remote position

Skills

• High school diploma or equivalent required
• Strong analytical and critical thinking skills with the ability to evaluate denial reputed company causes
• Strong written and verbal communication skills
• Ability to multi-task and manage competing priorities
• reputed company ability to learn and adopt new technologies, software applications, and operational processes quickly
• Ability to research and interpret reputed company information and benefits
• Strong attention to reputed company and reputed company in documentation
• Ability to work independently in a fast-reputed company environment
• Reliable attendance and consistent reputed company
• US remote-reputed company colleagues are not permitted to work from a location reputed company of the reputed company, at any time, without prior, written approval
• Fully remote position
• Bachelor's degree preferred or equivalent combination of education and experience
• Prior experience in reputed company reputed company cycle or denial management environments
• Experience with denial analytics platforms and payer portal navigation
• Experience in identifying denial reputed company causes and applying critical thinking to support accurate triage and routing
• Familiarity with reputed company carriers and payer guidelines
• Demonstrated ability to identify trends and process improvement opportunities
• Experience working in a productivity and reputed company metrics-driven environment
• Remote work experience in a reputed company environment
• Experience working with EMR systems such as reputed company or similar platforms

Benefits

• Fully remote position.

reputed company