Valley Children's Healthcare

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Underpayment Analyst-VCMG - General & Admin

at Valley Children's Healthcare

Posted: 2/5/2019
Job Reference #: 3252

Job Description

Underpayment Analyst-VCMG - General & Admin

SUMMARY: This position ensures all claim payments made to Valley Children's Medical Group are accurate in relationship to the contractual terms and applicable fee schedules. This position utilizes technology and customized reports to audit all claims payments to identify underpaid claims and work with payors to obtain corrected payments for services rendered to their members as well as resolving systemic underpayment issues. This position partners with the Revenue Cycle Physician Billing team to provide education and training.

JOB REQUIREMENTS: High School Diploma/G.E.D. required. College Degree - 4 year in Business related field preferred. Minimum four (4) years experience in a hospital or health insurance industry setting required. Familiar with managed care contract language as it relates to expected reimbursement required. Familiar with health insurance billing and coding required. Strong mathematical and analytical skills required. Effective oral and written communication skills required. Medical billing/collections/Business Office experience in physician practice, clinic/hospital care setting preferred. Advanced Microsoft Office application skills.



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