Revenue Integrity Analyst: Underpayments & Recovery

lmh; Lawrence (KS); On-site; USD 75,000 - 105,000; Full time

Benefits offered by this job

Tuition reimbursement to support CE

Professional development and career成长

Excellent benefits

Job summary

LMH Health is seeking an Underpayment Analyst to identify, analyze, and recover physician underpayments. The role collaborates with Patient Accounts, Coding, Contracting, Finance, and Operations to improve revenue integrity and reduce leakage.

The position requires an Associate degree and 3+ years in physician revenue cycle or related fields, with CPC/CCS/CRCR/CRIP preferred. Kansas-based hospital with strong community focus and growth opportunities.

Qualifications

• Associate degree in Business, Finance, Healthcare Administration, Health Information Management, or related field.
• Three (3) years of experience in physician revenue cycle operations, payer reimbursement analysis, revenue integrity, denials management, or related healthcare financial functions.
• Experience interpreting payer contracts, physician fee schedules, and reimbursement methodologies.
• Experience working with Medicare, Medicaid, and commercial payer reimbursement models.

Responsibilities

• Review reimbursement activity to identify underpaid physician claims and payment variances.
• Analyze reimbursement against payer contracts, fee schedules, and payment methodologies.
• Investigate and quantify underpayments related to coding edits, modifiers, multiple procedure reductions, bundling rules, place-of-service differentials, and other reimbursement methodologies.
• Prepare and submit payer disputes, appeals, and reconsideration requests.
• Track recovery efforts and maintain documentation supporting findings and outcomes.
• Monitor and report underpayment recoveries and reimbursement opportunities.
• Monitor payer adherence to negotiated reimbursement terms and contractual provisions.
• Utilize contract management and reimbursement analysis tools to validate claim payments and identify variances.
• Identify patterns of payer non-compliance and recommend corrective action.
• Collaborate with Contracting, Revenue Integrity, and Information Technology teams to maintain accurate contract configuration and payment modeling.
• Analyze reimbursement trends, payer performance, and recovery metrics.
• Prepare reports and dashboards that support reimbursement optimization and revenue cycle performance.
• Identify root causes of reimbursement discrepancies and recommend process improvements.
• Present findings and recovery opportunities to leadership and operational stakeholders.
• Partner with Coding, Billing, Denials, and Contracting teams to resolve reimbursement issues.
• Support initiatives that improve reimbursement accuracy, clean claim performance, and payer compliance.
• Develop and maintain procedures related to underpayment identification and recovery activities.
• Recommend workflow improvements and automation opportunities that enhance recovery efforts and reduce revenue leakage.

Skills

Physician revenue cycle experience

Payer reimbursement analysis

Contract interpretation

Medicare/Medicaid knowledge

Education

Associate degree in Business, Finance, Healthcare Administration, Health Information Management, or related field

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or related field

Certifications: CPC, CCS, CRCR, CRIP

Tools

Contract management software

Reimbursement variance software

Job description

LMH Health is seeking an Underpayment Analyst to identify, analyze, and recover physician underpayments. The role collaborates with Patient Accounts, Coding, Contracting, Finance, and Operations to improve revenue integrity and reduce leakage.

The position requires an Associate degree and 3+ years in physician revenue cycle or related fields, with CPC/CCS/CRCR/CRIP preferred. Kansas-based hospital with strong community focus and growth opportunities.