Provider Services Analyst I

About the Role

TREND Health Partners is a tech-enabled payment integrity company seeking a Provider Services Analyst I to facilitate collaboration between payers and providers for waste reduction and improved healthcare access.

Key Responsibilities:

• Analyze claims to determine recovery options and identify root causes for denials.
• Draft detailed and convincing correspondence to effectuate reimbursement.
• Contact insurance carriers, patients, attorneys, and employers to facilitate resolution.
• Interpret contracts regarding reimbursement timelines and payer responsibilities.
• Utilize payer portals, EMR systems (Epic, Cerner), and claims recovery software to advance revenue cycles.
• Document all claim actions clearly and concisely within the tracking system.

Qualifications:

• Prior experience in reviewing, processing, and recovering post-service denials (preferred).
• Knowledge of UB04s, Claim Adjustment Reason Codes (CARC), and Remittance Advice Reason Codes (RARC).
• Experience navigating EMRs such as Cerner and Epic.
• Strong analytical, multi-tasking, and verbal/written communication skills.
• Understanding of medical terminology and proficiency in Microsoft Office products.
• High School Diploma with some college preferred.

Required Skills