Underpayment Recovery Analyst

Underpayment Recovery Analyst

At Summit Orthopedics, we recognize the impact each member of the Summit Family has on one another and on our patients every day. Join a patient-first environment where our values Better Together, Own It, Nimble, Excellence, and Service are lived down to our BONES. At Summit, team members feel respected, valued, and connected to meaningful work, contributing to a collaborative, community-centered culture built on mutual respect and enjoyment. The Underpayment Recovery Analyst is responsible for capturing lost revenue due to underpayments as well as serving as a contract resource to other Summit teams needing assistance or escalation of issues. This is a full time position based at our Corporate Office located in Woodbury, MN. Monday - Friday schedule; standard business hours (schedule subject to change). Use contract management system to audit, track and quantify variances between actual and expected insurance payments for facility and professional claims. Maintain productive working relationships with provider relations contacts at the payers and submit effective appeals for underpaid accounts and follow-up timely until resolved. Share trending payer payment issues, root causes, billing optimization and contract term improvement considerations with management in order to increase overall performance. Conduct ongoing payer monitoring, including review of payer newsletters, provider manuals, bulletins and regulatory communication, and communicate operational impacts and required follow-up to stakeholders. Partner with revenue cycle, business office, business analytics, credentialing, and operational leaders, as well as payer representatives, to resolve contract related issues. Serve as a resource to Summit for contract interpretation as well as claims that need to be escalated. Performs Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for cases to be performed in-house or scheduled at a hospital. Other duties as assigned. Summit's hiring range for this position is $51,943 to $64,929 annually. The hired candidate may be eligible to receive additional compensation in the form of bonuses, differentials and/or deferred compensation. In addition to our base salary, we offer a comprehensive total rewards package that aligns with our vision of leading a healthy and active lifestyle. This includes medical, dental, vision, disability, life insurance, paid time off and 401(k)/profit sharing retirement plan. If you are hired at Summit, your final base salary compensation will be determined based on factors such as skills, education, experience, and internal equity. Summit Orthopedics provides the Twin Cities, Greater Minnesota and Western Wisconsin with the full spectrum of orthopedic care including sub-specialty clinics, walk-in care at our Orthopedic Urgent Care clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert team of physicians, surgeons, physician assistants, certified athletic trainers and therapists are part of the 1,200+ employees who partner to provide quality care designed to support a healthier, more active lifestyle. Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Qualifications

Education: High School or better. Some post college or better preferred.

Experience: Extensive knowledge of managed care and government payer practices and requirements as well as healthcare coding and billing knowledge. Prior experience with reporting, data queries and analytics. Experience with medical software (PM, EMR, EHR) Minimum of four years of billing experience in a business office setting.