[Remote] Recovery Analyst - Underpayments

Remote, USA Full-time
Note: The job is a remote job and is open to candidates in USA. TREND Health Partners is a tech-enabled payment integrity company focused on improving access to healthcare. The Underpayment Recovery Analyst is responsible for reviewing and resolving underpaid hospital claims, conducting analyses of claim payments, and preparing appeals to optimize client reimbursement. Responsibilities • Perform 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 client-specific contract terms • Accurately identify and categorize underpayment types and root causes (e.g., pricing discrepancies, DRG/APC miscalculations, bundling errors, inappropriate denials) • Initiate rebilled or corrected claims and manage timely follow-up on outstanding underpaid or denied claims • Prepare and submit detailed appeals with appropriate documentation and contract references to secure accurate reimbursement • Track outcomes and escalate unresolved issues as needed • Interpret complex hospital managed care contracts, fee schedules, payer policies, and government payer reimbursement policies • Validate expected reimbursement across multiple payer types (e.g., Medicare Advantage, Medicaid, Commercial) • Identify and document systemic payer issues and trends affecting reimbursement • Partner with internal teams and client stakeholders to recommend process improvements, payer escalations, or system configuration changes • Meet or exceed established internal Key Performance Indicators (KPIs) related to claims reviewed, identifications, recovery amounts, appeal turnaround times, and accuracy • Maintain up-to-date and organized case documentation in internal systems and client-facing portals Skills • 3–5 years of experience in healthcare revenue cycle, with a strong focus on underpayment/zero balance review, and payer reimbursement analysis • Understanding of hospital managed care contracts and reimbursement methodologies (e.g., DRG, APC, percent-of-charge, per diem) • Experience with contract modeling tools and hospital billing systems (e.g., Epic, Cerner, Meditech) • Knowledge of payer-specific policies, billing regulations, and denial types (technical and clinical), payer-specific portals and dispute resolution processes • Knowledge of CMS, Medicare Advantage, and state Medicaid plan rules • Strong analytical skills with the ability to interpret complex data and identify trends or discrepancies • Excellent written and verbal communication skills • Proficient in Microsoft Excel and other data analysis/reporting tools Benefits • Health insurance • 401(k) plan with employer match • Paid parental leave Company Overview • Trend Health Partners 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 Apply tot his job
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