... root cause analysis to ensure compliance and identify patterns of underpayment or denial ... At least 2 years in a supervisory or team lead role , preferably with remote or offshore team ...
... root cause analysis to ensure compliance and identify patterns of underpayment or denial ... At least 2 years in a supervisory or team lead role , preferably with remote or offshore team ...
Excellent analytical, communication and organizational skills with strong attention to detail. Self ... Prepares remote bank deposits and processes credit card transactions daily with 100% accuracy.
Excellent analytical, communication and organizational skills with strong attention to detail. Self ... Prepares remote bank deposits and processes credit card transactions daily with 100% accuracy.
Remote Underpayment Analyst information
What are the key skills and qualifications needed to thrive as a Remote Underpayment Analyst, and why are they important?
To thrive as a Remote Underpayment Analyst, you need strong analytical skills, knowledge of medical billing and reimbursement processes, and typically a degree in finance, healthcare administration, or a related field. Familiarity with claims management systems, Excel, and often certifications like Certified Revenue Cycle Specialist (CRCS) or Certified Professional Coder (CPC) is valuable. Attention to detail, problem-solving abilities, and effective written communication are crucial soft skills for this role. These skills ensure accurate identification and resolution of payment discrepancies, directly impacting revenue recovery and organizational efficiency.
How does a Remote Underpayment Analyst typically collaborate with other departments to resolve payment discrepancies?
Remote Underpayment Analysts frequently work with teams such as billing, claims, and customer service to investigate and resolve payment discrepancies. They often communicate via email, video calls, and shared documentation tools to gather necessary details, clarify issues, and ensure timely resolution. Building strong relationships and maintaining clear communication with these departments is key, as problem-solving often requires input from multiple stakeholders. This collaborative approach enhances efficiency and ensures accurate and consistent financial outcomes.
What is a Remote Underpayment Analyst?
A Remote Underpayment Analyst is a professional who works from a remote location to review, investigate, and resolve payment discrepancies, typically within healthcare, insurance, or financial services. Their primary responsibility is to identify cases where payments received are less than what was expected or contractually agreed upon. They analyze claims, contracts, and payment data to determine the root cause of underpayments and often communicate with payers or clients to recover lost revenue. This role requires strong analytical skills, attention to detail, and knowledge of billing and reimbursement processes. Working remotely, they use digital tools and secure platforms to perform their duties efficiently.
What is the difference between Remote Underpayment Analyst vs Remote Billing Specialist?
| Aspect | Remote Underpayment Analyst | Remote Billing Specialist |
|---|---|---|
| Required Credentials | Typically requires a degree in finance, accounting, or related field; certifications like CPC or CPA are common | Usually requires a high school diploma or associate degree; certifications like CPC are beneficial but not mandatory |
| Work Environment | Remote, healthcare or insurance companies, finance departments | Remote, healthcare, insurance, or healthcare provider organizations |
| Employer & Industry Usage | Used in healthcare, insurance, and finance sectors to identify and resolve underpayments | Commonly employed in healthcare and insurance to process and manage billing |
The Remote Underpayment Analyst focuses on identifying and resolving underpayments in healthcare or insurance claims, requiring analytical skills and specific certifications. In contrast, the Remote Billing Specialist handles billing processes, often with less emphasis on analysis. Both roles are remote and industry-specific, but their core responsibilities differ significantly.
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Full-time
Re-posted 20 days ago
Job description
Manager, Post-Pay Audit
Job Summary:
We are seeking a detail-oriented and driven Post-Pay Audit Manager to lead a team of auditors performing retrospective audits across commercial and government payers. Reporting directly to the Director of Post-Pay Audit, this role is responsible for daily operations management, performance oversight, and quality assurance across onshore and offshore teams, including staff based in the Philippines.
The ideal candidate has experience in medical claims auditing, strong leadership capabilities, and a solid understanding of Medicare, Medicaid, and other payer reimbursement requirements. This position plays a key role in maximizing revenue recovery while ensuring compliance and process excellence.
Key Responsibilities:
- Supervise daily audit operations across onshore and offshore teams, ensuring accuracy, productivity, and timely completion of audit deliverables.
- Provide hands-on leadership, training, and mentorship to audit staff, fostering a high-performance and quality-focused team culture.
- Monitor performance metrics, individual KPIs, and quality assurance results to drive continuous improvement.
- Coordinate the execution of audits for government (RAC, UPIC, MAC) and commercial payers, ensuring adherence to payer policies and audit guidelines.
- Collaborate with the Director of Post-Pay Audit on staffing, planning, and workflow optimization across multiple time zones.
- Conduct regular audit reviews, spot checks, and root cause analysis to ensure compliance and identify patterns of underpayment or denial.
- Escalate complex audit findings or payer discrepancies to senior leadership as needed.
- Assist in the development and implementation of standard operating procedures (SOPs) and training documentation.
- Support audit readiness and documentation for internal and external quality audits.
- Foster strong communication between onshore and offshore teams to ensure alignment on goals and expectations.
Qualifications:
- Bachelor’s degree in Healthcare Administration, Health Information Management, Business, or related field required.
- Minimum of 5 years of experience in medical auditing, revenue cycle management, or claims recovery.
- At least 2 years in a supervisory or team lead role, preferably with remote or offshore team management experience.
- Solid knowledge of government audit programs (RAC, MAC, Medicaid Integrity, UPIC) and commercial payer policies.
- Proficiency in healthcare billing, medical coding (ICD-10, CPT, HCPCS), and EOB analysis.
- Strong analytical, organizational, and decision-making skills.
- Experience using audit/recovery software platforms and workflow tools.
- Professional certification preferred (e.g., CPMA, CPC, RHIA, CHC).
- Ability to work cross-functionally in a dynamic, deadline-driven environment.
About Health Business Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Cooper City, FL, US
Year founded
2002