Underpayment Analyst
Job Description
Job Description
Position Summary
Reviews hospital claims data to identify underpayments and pursue resolutions with third party payors.
Job Duties
- Review hospital-managed care contracts: To determine expected reimbursements and identify potential underpayments. Familiarize yourself with the rates.
- Assist with ensuring software is accurately estimating the expected payment amounts. Provide feedback to the Contract Management software team any updates or modifications needed
- Utilize Contract management software to identify contractual discrepancies and billing errors.
- Communicate with third-party payers via correspondence and phone to resolve claims and recover lost revenue.
- Work with inter-departmental customers (HIM, Registration, IT, Clinical departments) to gather necessary information and documentation to support appeals and resolutions.
- Maintain records of actions taken and resolutions achieved.
- Generate reports and queries: Use software like Microsoft Excel and Contract Management Software to analyze data and create reports.
- Provide feedback to management regarding trends and issues
- Adhere to policies and procedures related to HIPAA, FDCPA, and other applicable laws.
- Performs other duties as assigned
Qualifications and Skills
- Ability to identify trends, patterns, and discrepancies in data.
- Excellent communication skills: Ability to communicate effectively with both internal staff and external payers.
- Strong organizational skills: Ability to manage multiple tasks and prioritize work effectively.
- Proficiency in relevant software: Familiarity with claims management systems, billing software, and Microsoft Excel.
- Knowledge of healthcare industry: Understanding of coding, billing, and reimbursement processes.
Education, Experience and Certification/Licensure Requirements
- Experience with denials and underpayments: Previous experience in pursuing resolutions with third-party payers.
- High school diploma or GED required.
- Two or more years of experience: In managed care reimbursement, hospital billing, or related fields is preferred.
- Bachelor's degree: In finance, economics, business, or a related field is often preferred but not required.
Recommended Jobs
Hair Stylist
Job Description Job Description Job Summary Grow with us! We are seeking a talented and motivated Hair Stylist to join our dynamic team. We are a busy, established, salon located in the heart …
Barista
Job Description Job Description Benefits/Perks Flexible Scheduling Competitive Compensation Career Advancement Opportunities Job Summary We are seeking a friendly and outgoing …
Associate
Job Title: Associate Location: Morris Cancer Center Department Name: Radiology Support Services Req #: 0000251328 Status: Hourly Shift: Evening Pay Range: $17.88 - $25.10 per hour …
Certified Medical Assistant (Float Pool) - Northeast Region, NJ
Job Title: Certified Medical Assistant Location: Barnabas Health Medical Group Department Name: Nursing Float Pool Req #: 0000244503 Status: Hourly Shift: Day Pay Range: $22.52 - $22…
Medical Technologist
Job Title: Medical Technologist Location: Jersey City Medical Center Department Name: Lab JCMC Req #: 0000253352 Status: Hourly Shift: Evening Pay Range: $38.48 - $51.29 per hour …
Part-Time/Per-Diem X-Ray Tech
We are seeking a Part-Time, skilled X-ray Technician to work three days per week at our multispecialty surgical center located in Mountainside, NJ. The ideal candidate will have experience running a …
Infusion Patient Care Coordinator - Annandale, NJ - Part Time
Position Summary The Infusion Patient Care Coordinator is responsible for providing administrative support to ensure the efficient operation of the medical office. You will support medical staff a…
Incident Response/ Forensic Lab Constructor
Job Description Job Description Description: Experience: Applicant must be US citizen and hold active DoD Secret Clearance Validated 3-5 years of specialized experience in Cybersecurity …
EMT or Paramedic (PRN)
Medcor is looking to hire an EMT or Paramedic on a PRN basis (as-needed) to be an Onsite Health Technician in our employer based, occupational health clinic in Swedesboro, NJ. The clinic operates Mond…