Revenue Cycle Underpay Analyst

This is a fully remote position, open to applicants in Florida.

📋 Description

• Examine submitted claims to detect discrepancies in reimbursements and underpayments.

• Evaluate payer reimbursements in relation to contract terms, fee schedules, and reimbursement methods.

• Calculate anticipated reimbursement amounts and assess variances.

• Initiate and oversee recovery of underpayments through appeals, reconsiderations, and escalations with payers.

• Document observations, recovery efforts, and results.

• Analyze managed care contracts, payer fee schedules, and reimbursement policies.

• Monitor payer adherence to contractual commitments.

• Identify systemic reimbursement challenges and propose corrective measures.

• Collaborate with Contracting teams regarding ongoing payer payment inconsistencies.

• Create and sustain underpayment tracking reports and dashboards.

• Analyze reimbursement patterns and pinpoint revenue recovery prospects.

• Assess the financial impact of payer underpayments and communicate findings to leadership.

• Prepare monthly and quarterly recovery performance reports.

• Work alongside AR, Coding, HIM, Credentialing, and Contracting teams to address reimbursement concerns.

• Assist in payer meetings by providing underpayment analysis and documentation.

• Support root cause analysis for denials, payment discrepancies, and payer processing mistakes.

• Engage in revenue integrity initiatives aimed at optimizing reimbursement.

• Ensure that recovery efforts align with payer requirements, contracts, and regulatory standards.

• Uphold confidentiality of patient and financial data in compliance with HIPAA regulations.

• Stay updated on reimbursement methods, payer policies, and industry best practices.

⛳️ Requirements

• At least 3 years of experience as a Business Analyst in healthcare environments.

• Experience with a large and expanding healthcare organization.

• Capability to handle multiple assignments and adhere to deadlines.

• Exceptional attention to detail and precision.

• Proficiency in presenting financial insights to operational and executive teams.

• Strong analytical and critical thinking abilities.

• Skill in interpreting complex payer contracts and reimbursement methodologies.

• Excellent communication skills, both written and verbal.

• Strong organizational and project management skills.

• Ability to adhere to HIPAA confidentiality requirements and relevant regulatory standards.

🏝️ Benefits

• Consistent working hours.

• No weekends or evenings — Monday through Friday.

• Paid holidays.

• Paid time off.

• Work/life balance.

• Opportunities for career advancement.

• Competitive salary.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Spending accounts.

• Life / AD&D insurance.

• Disability insurance.

• Accident insurance.

• Critical illness insurance.

• Hospital indemnity insurance.

• Legal benefits.

• Identity theft protection.

• Pet benefits.

• 401(k) retirement plan with Non-Elective Safe Harbor employer contribution for eligible employees.

• Discretionary profit-sharing with employer contributions ranging from 0% to 4% for eligible employees.

• Discounts on concerts, travel, movies, and more through Tickets at Work.