Revenue Cycle Denial & Underpayment Specialist

Responsibilities

• Comparison of contracted rates versus claim payment to identify underpayments for assigned payers.
• Identify and resolve denials and underpayments.
• Review contract management system to explain and resolve denials and arrange for payment or adjustment.
• Collaborates with other departments to obtain clinical data to resolve denials or underpayments.
• Performs special projects as needed and assigned.
• Performs other duties as assigned.

Qualifications

• High School Diploma
• Minimum three (3) years’ experience in denials, underpayments, or healthcare accounts receivable.
• Ability to analyze and reconcile multiple accounts and large volumes of claim data.
• Working knowledge of denial and underpayment processes.