Underpayment Analyst

About the company

• Healthcare revenue integrity team helping hospitals recover entitled reimbursement; role listed via partner company.

Responsibilities

• Analyze hospital claims to identify discrepancies between expected and actual reimbursements.
• Investigate underpayments and payment variances (coding errors, billing discrepancies, payer policy).
• Contact insurance carriers to resolve underpayment cases and coordinate payment processing.
• Prepare and submit documentation to support reimbursement recovery (letters, appeals, adjustment requests).
• Maintain records of investigations, root causes, and resolution outcomes.
• Interpret payer reimbursement guidelines (Medicare, Medicaid, commercial insurance).
• Collaborate with internal teams and insurance representatives.

Requirements

• High school diploma or equivalent.
• Strong investigative, analytical, problem-solving skills.
• Knowledge of healthcare billing, medical coding, reimbursement methodologies.
• Ability to interpret Medicare, Medicaid, commercial insurance policies.
• Familiarity with HIPAA, CMS regulations.
• Experience with Epic, Cerner, Meditech desirable.
• Proficiency with Microsoft Office (Excel, Word, Outlook).
• Dedicated home workspace and reliable internet (20 Mbps down / 10 Mbps up).
• Reside in eligible US states; work authorization and background check required.

Conditions

• Full-time remote for eligible US states.
• Structured 90-business-day training program.