The Underpayment Projects Lead is the lead over payment variance review, identifying, validating, and partnering with client’s Payer Contracting team and coordinating with Insurance Provider Representatives to escalate and push issues through to resolution.
- The Underpayment Projects lead will serve as a point of contact for the client’s Payer Contracting team regarding requests for relevant issues including reports or example packets as it relates to variance issues.
- Reviews variance monitoring reporting at a high level to identify and validate over and under variances and prepare for escalation.
- Coordinates with global partner to support in the claim level review process for specific outlined payer trends and high dollar drug variances. Supports/providers guidance where needed on appeal submission and reprocessing tactics.
- Supplies support with client Audit requests on an as needed basis (typically biannually). Team will pull RCM related documentation for these audits.
- High School Diploma or GED required; Bachelor’s Degree in Business, Accounting, or Healthcare related field, preferred.
- Two years of medical billing experience required.
- Working knowledge of accounts receivables and management principles; ability to calculate figures and amounts such as discounts, interest, and percentages.
- Working knowledge of payer processes.
- Proficient with the accounts receivable billing system and internet tools, (e.g., eligibility websites, address search engines); ability to perform basic reviews of accounts in the practice management system to determine status.
- Competency in Microsoft Office tools including but not limited to word, excel, and Outlook.
- Integra Connect, LLC provides a comprehensive benefits plan.
- Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
- Paid Time Off
- 401k with employer match
- Paid Holidays and Floating Holiday
Equal Opportunity Employer