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HCA Healthcare · 13 hours ago

Senior Underpayment Analyst

United States

Full-time

Remote

Mid, Senior Level

2+ years exp

HCA Healthcare is a leading organization committed to investing in its team members, and they are seeking a Senior Underpayment Analyst to join their team. The role involves researching and resolving high dollar insurance payer underpayments and requires strong analytical and communication skills to navigate complex payer contracts and claims processing.

BiotechnologyHealth CareHospitalMedicalPrimary and Urgent Care

Responsibilities

Analyzes hospital claims to identify contractual underpayments or billing errors

Resolves underpaid claims from various payer products including HMO, PPO, Medicaid, Medicare and Workers' Compensation

Articulates contract provisions to representatives from healthcare payer companies and government agencies

Contacts payer companies via phone or correspondence and initiates request for payment

Performs appropriate follow up with Payer and gains commitment for payment

Escalates Payer lack of response and/or lack of payment within Payer organization as appropriate

Identifies and communicates contract interpretation issues and language discrepancies to leadership as appropriate

Identifies Payer company trends and communicates trends to supervisor for further action/escalation

Serves as a subject matter expert in Payer contract dispute resolution process

Qualification

Payer Contract AnalysisClaims ProcessingMathematical AcumenCritical ThinkingData AssimilationRelationship ManagementPersuasion SkillsCommunication Skills

Required

Bachelor's degree in business or related field required. Relevant work experience may substitute degree requirements

Two years of related experience preferred

High mathematical acumen

Ability to access and assimilate data

Articulate a strong case

Confidence and strong persuasion skill set

Results oriented individuals

Ability to grow strategic payer relationships

Understanding of payer system to navigate through claims processing centers

Critical thinking skills

Ability to see trends that require escalation to the Payment Compliance Director

Preferred

Two years of related experience preferred

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

Free counseling services and resources for emotional, physical and financial wellbeing

401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

Employee Stock Purchase Plan with 10% off HCA Healthcare stock

Family support through fertility and family building benefits with Progyny and adoption assistance.

Referral services for child, elder and pet care, home and auto repair, event planning and more

Consumer discounts through Abenity and Consumer Discounts

Retirement readiness, rollover assistance services and preferred banking partnerships

Education assistance (tuition, student loan, certification support, dependent scholarships)

Colleague recognition program

Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Company

HCA Healthcare

Glassdoor3.3

HCA Healthcare provides medical education and healthcare services in locally managed facilities. It is a sub-organization of North Florida Endoscopy Center.

Founded in 1968

Nashville, Tennessee, USA

10001+ employees