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Company Name:
nThrive
Approximate Salary:

Location:
Saddle River, New Jersey
Country:
United States
Industry:
Other
Position type:
Unspecified
Experience level:
Education level:

Underpayment Recovery Analyst


nThrive


Equal Opportunity Employer EOE M/F/D/V

Job ID 2017-20932
Employment Type full-time
Job Location US-NJ-Saddle River
Hours Per Week 0.00


Overview

The Underpayment Recovery Analyst will play a key role in the Underpayment Recovery team by reviewing claim and payment information through contract management and underpayment identification systems to identify potential individual underpayments and underpayment trends. Identified potential underpayments and trends will be analyzed and screened to remove false positives, enabling other team members to accurately and efficiently pursue lost revenue on behalf of Underpayment Recovery clients.

Responsibilities

  • Makes use of high volume reports to review historical payment information and determine the accuracy of reimbursements
  • Reviews hospitals managed care contracts to determine appropriate application of rates, provisions and terms
  • Identifies potential underpayment trends through comparison of managed care contracts to actual reimbursement information via contract management technology
  • Applies analytical techniques during report review to remove inaccurate information and potential false positive returns
  • Investigates third party payor policies and contracts to verify accuracy of underpayment variances according to published payor guidelines
  • Interfaces with Underpayment Contract Analysis team to refine contract models if discrepancies are identified
  • Makes initial contact with payor to verify patient benefits and eligibility to screen out denials, plan type and other demographic information that may negatively impact the accuracy of identified potential underpayment trends
  • Reports underpayments and underpayment trends to management and audit team for pursuit and collection
  • Meets established individual and team goals for volume and value of underpayments identified


Qualifications



  • BA/BS in business or related concentration
  • Minimum 3 years' experience in healthcare operations and data
  • Proven knowledge and experience in managed care contracts
  • Demonstrated ability to work in a team environment that requires quick turnaround and quality output.
  • Solid knowledge of all MS Office Products.
  • Strong analytical acumen
  • Excellent oral and written communication skills
  • Clinical experience in areas of the Operating Room, Materials Management, Laboratory, Nursing or other clinical areas
  • Experience with Access


About nThrive

nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we've combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.

nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.

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