Helix Advisory · 1 day ago
Underpayment Audit & Recovery Specialist (Contract/Full Time)
United States
Full-time, Contract
Remote
Mid Level
3+ years expHelix Advisory is a leading healthcare consulting firm dedicated to optimizing revenue cycle management for healthcare organizations. The Contract Analyst/Underpayment Specialist is responsible for analyzing payer contracts, identifying underpayments, and implementing strategies to recover lost revenue. This role requires a detailed understanding of healthcare reimbursement and effective negotiation skills with payers.
AnalyticsFinancial ServicesProfessional Services
Hiring Manager
Gidget Bowers EHRC, CRCR
Responsibilities
Review and interpret payer contracts to ensure compliance with agreed terms
Identify discrepancies between contracted rates and actual payments received
Analyze claims data to identify patterns of underpayment or discrepancies in reimbursement
Develop reports and dashboards to track underpayment trends and recoveries
Implement strategies to recover underpayments from payers, including preparing and submitting appeals
Collaborate with billing and coding teams to address root causes of underpayments
Engage with payers to negotiate and resolve underpayment issues
Maintain professional and effective communication with payers to facilitate timely resolution of claims
Ensure all activities comply with regulatory requirements and industry standards
Prepare detailed reports on underpayment recovery efforts and outcomes for management review
Identify opportunities for process improvement within the revenue cycle to reduce future underpayments
Collaborate with cross-functional teams to implement best practices and enhance operational efficiency
Qualification
Required
Bachelor's degree in Finance, Healthcare Administration, Business, or a related field
Minimum of 3 years of experience in healthcare revenue cycle management, contract analysis, or claims processing
Proven track record of successful underpayment recovery and negotiation with payers
Strong analytical skills with the ability to interpret complex contracts and reimbursement data
Excellent communication and negotiation skills
Proficiency in using healthcare billing software and Microsoft Office Suite (Excel, Word, PowerPoint)
Detail-oriented with strong organizational and time management abilities
Certified Revenue Cycle Professional
Company
Helix Advisory
Helix Advisory offers healthcare revenue cycle consulting, using AI and automation to optimize workflows and recover payments.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase