Payment Variance Analyst

Med-Metrix

. Identify opportunities to pursue additional reimbursement due to contractual payment discrepancies .

Posted 11/9/2026full-timeRemote • New Jersey • United StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing payment discrepancies and underpayment trends within managed care reimbursement methodologies, while ensuring compliance with HIPAA standards. Proficient in collaborating with cross-functional teams to resolve billing issues and enhance claims collection processes.

Highest-signal resume keywords

Managed Care Reimbursement MethodologiesPayment Variance AnalysisCommercial Insurance CollectionsMicrosoft Office Suite ProficiencyUnderpayment Analyst Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payment Variance AnalysisClaims Submission and Follow-UpBilling and Coding Error ResolutionData AnalysisContractual Payment Discrepancy IdentificationPayer Underpayment Data PreparationClient Heat Map AnalysisAppeals InitiationTrend ReportingSystematic Issue Tracking

Soft Skills

Strong Interpersonal SkillsExcellent Written CommunicationExcellent Verbal CommunicationProblem Solving SkillsAbility to Collaborate

Tools & Technologies

Microsoft Office SuiteElectronic Device for Multifactor Authentication

Industry Keywords

HIPAA ComplianceManaged Care ContractsHospital BillingInsurance ClaimsPayment Discrepancies

About the role

Key responsibilities & impact

Identify opportunities to pursue additional reimbursement due to contractual payment discrepancies
Use managed care contracts to determine whether appropriate rates, provisions, and terms are being followed by payers
Report root causes of identified payment discrepancies to the manager
Perform payment variance analysis to identify trends in underpaid claims
Request and prepare payer-underpayment data in a uniform format for internal Payment Variance Specialists to validate
Analyze data and work with Analytics and/or Pricing teams to resolve contract-load variances and produce accurate reporting
Analyze client heat maps monthly for accuracy
Identify and report underpayments and denial trends to client leadership
Track resolution and collection of underpaid claims
Escalate issues with payers or managed care teams for collection and resolution
Provide support and guidance to Payment Variance Specialists on projects and support the team as needed
Initiate appeals when necessary
Track recurring underpayment patterns and systematic issues
Analyze, identify, and resolve issues causing payer payment delays, including billing and coding errors
Protect and disclose patients’ PHI in accordance with HIPAA standards
Comply with Information Security and HIPAA policies and procedures
Limit viewing of PHI to the minimum necessary to perform assigned duties
Perform other duties as assigned

Requirements

What you’ll need

High school diploma or equivalent required
2 years’ experience in Commercial insurance collections, including submitting and following up on claims
2 years’ experience of underpayment analyst experience
Detailed knowledge of Managed Care reimbursement methodologies
Experience in Hospital/Facility billing
Ability to adapt to learning a wide range of systems and regulations
Proficiency in Microsoft Office Suite
Strong interpersonal skills and ability to communicate well at all levels of the organization
Strong problem solving and creative skills, with the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results orientation
Excellent written and verbal communication skills required
Gracious and welcoming personality for customer service interaction
Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
Ability to follow directions, collaborate with others, and handle stress