Revenue Cycle Underpay Analyst

Gastro Health is currently looking for an enthusiastic full-time Revenue Cycle Underpay Analyst.

Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours – and we enjoy paid holidays, plus paid time off.

This role offers:

- A great work/life balance

- No weekends or evenings – Monday thru Friday

- Paid holidays and paid time off

- Rapidly growing team with opportunities for advancement

- Competitive compensation

- Benefits package

Duties you will be responsible for:

- Essential Functions include but are not limited to the following:

- Review paid claims to identify reimbursement discrepancies and underpayments.

- Analyze payer reimbursements against contract terms, fee schedules, and reimbursement methodologies.

- Calculate expected reimbursement amounts and quantify variances.

- Initiate and track underpayment recovery efforts through appeals, reconsiderations, and payer escalations.

- Maintain detailed documentation of findings, recovery actions, and outcomes.

- Interpret managed care contracts, payer fee schedules, and reimbursement policies.

- Monitor payer compliance with contractual obligations.

- Identify systemic reimbursement issues and recommend corrective actions.

- Collaborate with Contracting teams to address recurring payer payment discrepancies.

- Develop and maintain underpayment tracking reports and dashboards.

- Analyze reimbursement trends and identify opportunities for revenue recovery.

- Quantify financial impact of payer underpayments and present findings to leadership.

- Prepare monthly and quarterly recovery reports.

- Partner with AR, Coding, HIM, Credentialing, and Contracting teams to resolve reimbursement issues.

- Support payer meetings by providing detailed underpayment analysis and supporting documentation.

- Assist in root cause analysis for denials, payment variances, and payer processing errors.

- Participate in revenue integrity initiatives designed to optimize reimbursement.

- Ensure all recovery activities comply with payer requirements, contractual obligations, and regulatory guidelines.

- Maintain confidentiality of patient and financial information in accordance with HIPAA regulations.

- Stay current on reimbursement methodologies, payer policies, and industry best practices.

Minimum Requirements

- Minimum of 3 years of experience as a Business Analyst in healthcare settings

- Experience with a large, growing healthcare organization.

- Technical or Administrative Knowledge:

- Ability to manage multiple priorities and meet deadlines.

- Strong attention to detail and accuracy.

- Ability to present financial findings to operational and executive leadership.

- Required Skills and Abilities and/or:

- Strong analytical and critical thinking skills.

- Ability to interpret complex payer contracts and reimbursement methodologies.

- Excellent written and verbal communication skills.

- Strong organizational and project management abilities.

We offer a comprehensive benefits package to our eligible employees:

- Medical

- Dental

- Vision

- Spending Accounts

- Life / AD&D

- Disability

- Accident

- Critical Illness

- Hospital Indemnity

- Legal

- Identity Theft

- Pet

- 401(k) retirement plan with Non-Elective Safe Harbor employer contribution for eligible employees

- Discretionary profit-sharing with employer contributions of 0% - 4% for eligible employees

Additionally, Gastro Health participates in a program called Tickets at Work that provides discounts on concerts, travel, movies, and more.

Gastro Health is the one of the largest gastroenterology multi-specialty groups in the United States, with over 130+ locations throughout the country. Our team is composed of the finest gastroenterologists, pediatric gastroenterologists, colorectal surgeons, and allied health professionals. We are always looking for individuals that sh