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Underpayment Specialist

Job ID: 4657826
Updated: June 15, 2018
Geographic Location: 
Department: Denials Underpayments
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

This position is located onsite with Mercy Health, a client of Ensemble Health Partners. To learn more about Mercy, click the link below to apply.

 

The Underpayment Specialist performs payment variance activities related to the incorrect processing of claims.

 

Job duties:

 

Include, but are not limited to, understanding insurance contract terms, reviewing underpayments to determine if additional payment amounts can be requested, identifying trends in payment discrepencies amongst payors, auditing correct payment amounts to ensure accuracy of contract, and working with contract management to identify opportunities when negotiating contracts with payors.

 

Underpayment Specialists responsibilities include understanding insurance contract terms, reviewing underpayments to determine if additional payment amounts can be requested, identifying trends in payment discrepencies amongst payors, auditing correct payment amounts to ensure accuracy of contract, and working with contract management to identify opportunities when negotiating contracts with payors. 

 

Underpayment Specialists receive their work from variances validated through the contract management software or the closed balance audit process. Items are referred to their for follow-up and collection via appeal or reconsideration.

 

Qualifications - Minimum

Required Minimum Education: 2 Yr. Associates Degree, specialty/major: Business or relevant discipline

 

Minimum Years and Type of Experience: 1-2 years experience in healthcare industry.

 

 

Skills and Abilities Preferred: Experience in physician and hospital operations, compliance and provider relations.  Managed Care contracting experience preferred.

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Hours

Full-time, 40 hours per week, days

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.

 

 

About Us

This position will be a part of the revenue cycle team at Ensemble Health Partners - a wholly owned subsidiary of Mercy Health. Ensemble Health Partners specializes in providing revenue cycle solutions and creating real value for its clients by building relationships, reducing revenue cycle spend and delivering exceptional results. Ensemble partners with hospitals across the United States to make real and lasting improvements that impact the bottom line.

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