Recovery Analyst - Underpayments

Role and 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.

Payer Follow Up and Appeals:

• 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.

Qualifications:

• 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.
• Experience with contract modeling tools and hospital billing systems.