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Underpayment & Contract Variance Analyst

Posted 5 days ago
2-5 years experience
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AI Summary

The analyst will review paid claims against payer contracts to identify and investigate reimbursement discrepancies. They will also coordinate with internal teams to facilitate payment recovery and prevent future revenue leakage.

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As an Underpayment & Contract Variance Analyst, you will analyze payer payments to identify instances where provider clients may have been reimbursed below their contracted rates. You will compare claims and payment data against payer contract terms, investigate discrepancies, and work with revenue cycle teams to support payment recovery and prevent recurring reimbursement issues.

WHAT YOU WILL DO

  • Review paid claims and compare reimbursement against applicable payer contract terms and fee schedules

  • Identify underpayments, incorrect adjustments, and other contract-related payment variances

  • Research claim history, payment details, and contract provisions to determine the cause of discrepancies

  • Quantify potential revenue recovery opportunities and prioritize issues for follow-up

  • Prepare supporting documentation for payment disputes, reconsiderations, and appeals

  • Coordinate with AR, denials, revenue integrity, and payer contracting teams to resolve identified variances

  • Track recovery activity and maintain accurate records of identified underpayments and outcomes

  • Identify recurring payer payment patterns and communicate findings to relevant teams

  • Prepare reports summarizing underpayments, recovery opportunities, and contract variance trends

WHAT WE ARE LOOKING FOR

  • 2+ years of experience in healthcare revenue cycle, reimbursement analysis, payment integrity, or a related role

  • Strong understanding of healthcare reimbursement, payer payments, and revenue cycle processes

  • Experience comparing payments against contracts, fee schedules, or expected reimbursement

  • Ability to interpret EOBs, ERAs, payment details, and payer information

  • Strong analytical and problem-solving skills with excellent attention to detail

  • Ability to research payment discrepancies and identify their root causes

  • Strong Excel skills and experience working with financial or claims data

  • Ability to communicate findings clearly and collaborate with billing, AR, and payer teams

  • Ability to work independently and manage multiple analysis and recovery priorities in a remote environment

  • HIPAA-compliant private workspace

NICE TO HAVE

  • Experience with Medicare, Medicaid, and commercial payer reimbursement

  • Knowledge of payer contracts and fee schedules

  • Medical billing or coding experience

  • Experience with revenue integrity or payment variance analysis

  • SQL, Power BI, or other data analysis experience

  • Experience working with provider groups or hospitals

COMPENSATION AND BENEFITS

Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, and relevant healthcare revenue cycle expertise.

Benefits and additional employment details will be discussed during the hiring process.

HIRING PROCESS

Application review → introductory conversation → hiring manager interview → offer.

EQUAL OPPORTUNITY

Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.

Location: Remote

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