Remote Recovery Analyst - Underpayment Specialist

About the Role

We are seeking a Remote Recovery Analyst to join our team at TREND Health Partners. This position focuses on underpayment recovery, ensuring that hospital claims are accurately reviewed and resolved. As a key player in our mission to improve healthcare access, you will work in a collaborative environment that emphasizes innovation and efficiency.

What You'll Do

• Conduct detailed analyses of remittances, explanations of benefits (EOBs), and payer correspondence 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, including pricing discrepancies and 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.
• Interpret complex hospital managed care contracts and validate expected reimbursement across multiple payer types.
• Identify and document systemic payer issues and trends affecting reimbursement, recommending process improvements as necessary.
• Meet or exceed established internal Key Performance Indicators (KPIs) related to claims reviewed and recovery amounts.

Requirements

• 3–5 years of experience in healthcare revenue cycle, specifically in underpayment recovery and payer reimbursement analysis.
• Strong understanding of hospital managed care contracts and reimbursement methodologies.
• Experience with hospital billing systems such as Epic, Cerner, or Meditech.
• Proficient in Microsoft Excel and other data analysis/reporting tools.
• Excellent written and verbal communication skills.

Nice to Have

• Knowledge of CMS, Medicare Advantage, and state Medicaid plan rules.
• Experience with contract modeling tools.
• Strong analytical skills with the ability to interpret complex data.

What We Offer

• Competitive salary ranging from $50,000 to $75,000 per year.
• Comprehensive health insurance and a 401(k) plan with employer match.
• Paid parental leave and other valuable benefits.
• A dynamic and collaborative work environment.
• Opportunities for professional growth and development.