Underpayments Specialist

Remote Jobs; Brasil; Teletrabalho; BRL 642.000 - 756.000; Tempo integral

Resumo da oferta

A leading healthcare technology firm seeks an experienced professional to analyze and refine underpayment detection processes. This fully remote role offers a salary up to $140,000 plus equity, comprehensive health plans, and generous paid leave. Ideal candidates will have over 8 years of experience in revenue cycle management and a strong grasp of payer reimbursement methodologies. Apply to join a mission-driven organization committed to equitable employment practices.

Serviços

Salary up to $140,000 base plus equity

Comprehensive medical, dental, and vision plans

Generous paid parental leave

Home office reimbursement stipend

Unlimited PTO and floating holidays

Professional development budget

Qualificações

• 8+ years of experience in hospital or health-system revenue cycle, underpayments, denials, or payer reimbursement integrity.
• Hands-on experience with EDI and payments data in reimbursement or analytics contexts.
• Strong understanding of payer reimbursement methodologies, such as DRG and fee-for-service.

Responsabilidades

• Collaborate with Product and Data Science teams on underpayment detection logic.
• Analyze claims and payment data to identify underpayment patterns.
• Translate payer contracts into actionable workflows.

Conhecimentos

8+ years of experience in hospital or health-system revenue cycle

Hands-on experience with EDI and payments data

Strong understanding of payer reimbursement methodologies

Experience interpreting payer contracts

Familiarity with UB-04/CMS-1500 forms

Descrição da oferta de emprego

Employer Industry: Healthcare Technology

Why consider this job opportunity:

• Salary up to $140,000 base plus equity
• Comprehensive medical, dental, and vision plans covering 90‑100% of premiums
• Generous paid parental leave of up to 12 weeks for birthing parents and 6 weeks for non‑birthing parents
• Fully remote work opportunity with a $400 home office reimbursement stipend
• Unlimited PTO and 10 holidays, including floating holidays for personal recognition
• Opportunities for professional development with a $500 annual budget for courses and resources

What to Expect (Job Responsibilities):

• Collaborate with Product and Data Science teams to define and refine underpayment detection logic using EDI and payments data
• Analyze claims and payment data to identify patterns of underpayment and revenue leakage
• Translate payer contracts and reimbursement methodologies into actionable workflows
• Review technology‑generated underpayment flags for accuracy against contract terms and claims data
• Serve as a subject matter expert on underpayments and advise on product development

What is Required (Qualifications):

• 8+ years of experience in hospital or health‑system revenue cycle, underpayments, denials, or payer reimbursement integrity
• Hands‑on experience with EDI and payments data in reimbursement or analytics contexts
• Strong understanding of payer reimbursement methodologies, such as DRG and fee‑for‑service
• Experience interpreting payer contracts and applying them to real claims data
• Familiarity with UB‑04/CMS‑1500 forms, revenue codes, and common CARC/RARC codes

How to Stand Out (Preferred Qualifications):

• Previous advising or consulting experience with healthcare technology companies
• Familiarity with CMS payment rules and regulatory guidance impacting reimbursement
• Experience leading teams focused on underpayment recovery or reimbursement optimization

We prioritize candidate privacy and champion equal‑opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.

We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top‑tier employer.