The Underpayment Analyst is responsible for accurately analyzing and collecting balances on all patient accounts according to federal/state laws and hospital preferred provider contracts. Working under minimal supervision, this position initiates contact with third parties to identify and subsequently resolve obstacles affecting reimbursement as well as provides feedback to internal parties related to issues impacting reimbursement claims.

Performs an audit review of insurance payment variances, to assure that all identifiable items and procedures have been accurately recorded.
Performs review and notification of maintenance required for the hospital Reimbursement Management contract files to ensure all carriers contracts and fee schedules are promptly updated as changes occur.
Reviews third party remittance advice, system reports, and explanation of benefits to assure compliance with expected reimbursement.
Researches circumstances related to insurance payment variance and analyzes the reasons for error.
Provides Education Coordinator examples of patterns that develop to assist in staff education.
Notifies Managed Care Coordinator when pattern appear to be developing regarding failure of third party payors to follow contractual guidelines.
Documents all action taken on accounts to allow anyone who looks at the account to know what has been done and that all procedures were followed.
Maintains a log/spreadsheet of all payment variances identified in Revenue Cycle to track resolution.
Pursues unsettled variance(s) as required to ensure that appropriate reimbursement is received from third party payers in a timely manner.
Performs other duties as assigned.
EDUCATION:Required: High School Diploma or equivalent
EXPERIENCE:Required: 3 years
LICENSURE/CERTIFICATION/REGISTRY/LISTING:
Equal Opportunity Employer At Cone Health, we strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of their race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, color, or any other characteristic protected by law. Our hiring and employment choices are based on each individual's qualifications, skills and performance. We believe that by embracing the diversity of our team, we can better serve our patients, communities and each other.