Underpayment Recovery Analyst (215382-043)
Medassets - Saddle River, NJ

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Career Level (internal use only): PYLW2Job Purpose: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.Essential Duties & 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
Minimum Knowledge, Competencies & Qualifications: Four-year degree Knowledge of/experience working with managed care contracts Strong analytical acumen Proficiency with MS Office Familiarity with hospital operations and data Strong leadership skills Excellent oral and written communication skills Physical Demands:The physical demands and work environment characteristics described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. The employee must occasionally lift and/or move up to 15 pounds. Mental Demands: the employee must be able to follow directions, to get along with others, and handle stress; Work environment: The noise level in the work environment is usually minimal.

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MedAssets is at the center of improving the quality and effectiveness of the healthcare industry. From establishing best practice value for...