Triage Analyst - Zero Balance

1. About Our Client: The organization operates in the healthcare revenue cycle management industry, specializing in collecting challenging payments from third-party payers. It focuses on complex denials, aged accounts receivables, motor vehicle accident claims, workers’ compensation, Veterans Affairs, and out-of-state Medicaid. The company supports hospital and health system partners by aiming to provide the highest revenue yield efficiently. With a team of over 1,400 members and a partnership with a private equity sponsor, the organization emphasizes client excellence and operational outcomes. 2. About the Opportunity: The Triage Analyst - Zero Balance will play a key role in supporting the Zero Balance team by analyzing hospital contracts and insurance reimbursement processes. This position is responsible for identifying underpayment trends, evaluating claim data, and assisting in revenue recovery efforts. The role contributes to improving client financial performance by providing insights into payment discrepancies and facilitating claim resolution. 3. Responsibilities: Review and interpret hospital contracts with insurance carriersAnalyze claims data to identify reimbursement discrepancies and recovery opportunitiesMonitor regulations impacting hospital reimbursement and assist in implementing audit flagsValidate payment variances and determine appropriate zero-balance audit reviewsCommunicate underpayment trends and collaborate with teams to route claims for recoveryProvide operational insights to support client performance and reimbursement optimizationIdentify denial root causes and assign denial categoriesReview documentation and communicate with payers and internal teams to clarify claimsMaintain accurate records of denial actions and escalationsPrioritize denials based on financial impact and regulatory requirementsRoute denied claims to appropriate resolution pathwaysAdapt to new technologies and process enhancementsEnsure compliance with payer guidelines, regulations, and organizational policiesWork independently and collaboratively to meet productivity and quality goals 4. Requirements: High school diploma or equivalentStrong analytical and critical thinking skillsEffective written and verbal communicationAbility to handle multiple prioritiesQuick adaptation to new technologies and processesCompetence in researching and interpreting insurance informationAttention to detail and accuracy in documentationAbility to work independently in a fast-paced environmentReliable attendance and consistent performance 5. Pay Range and Compensation Package: The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors. 6. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note: RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.