Representative, Payment Variance

Hey there! We’re Acclara.

As a remote-first workforce with team members in all 50 states, we’re a unique group of strategists, technologists, and service providers—all united in serving our partners to deliver the best care to their patients, helping build even healthier communities for us all to live and work in.

We bring our one-of-a-kind selves to work each day, and we welcome (and want) you to do the same. Coffee connoisseurs, moms and dads, runners, animal lovers, adventurists—the list goes on—we all came to make a difference, and we stay because we’ve found a place where we don’t have to do it alone.

Our team’s work is fueled by our CORE values of Commitment, Outcomes, Respect, and Empowerment. They’re the “how” behind what we do, guiding our actions as we aim to change the way technology and services come together.

The Role

The Payment Variance Representative will be responsible reviewing primary Payment Variance for all payers and balance amounts with claims tagged to Acclara inventory. Additionally, this role will determine whether an underpayment exists on the account, take the necessary adjustment/move the balance to self-pay, and submit underpayment appeals. Due to the nature of this team, the position will encounter Payer/Pricing Trends and work hand-in-hand with Payer Escalations. If a denial is discovered and action needs to be taken to obtain additional reimbursement, the account will be triaged and returned to the Insurance Services team.

What You’ll Do

• Investigating/identifying/correcting insurance registrations.
• Investigating/reversing/applying contractual adjustments.
• Investigating/transferring balances to Patient Solutions (self-pay).
• Identifying/triaging denials.
• Escalating denials to upper management that are not being captured under the appropriate CARC/RARC code.
• Identifying/triaging accounts needing an SCA/NSA negotiation process.
• Identifying/Billing balances to secondary insurance.
• Adjusting small balances.
• Adjusting clinical denials under appeal thresholds.
• Investigating/escalating pricing trends.
• Investigating/escalating payer trends.
• May assist with drafting/submitting underpayment appeals.
• Regularly meets/exceeds productivity and quality metrics.
• Other duties as assigned.

What We’re Looking For

• Highschool diploma or equivalent.
• 2 years in hospital revenue cycle and hospital underpayment review.
• 1 year navigating online portals and Meditech.
• 1 year navigating hospital contracts.
• Proven record of strong organization and planning skills and the demonstrated ability to effectively manage time and achieve results in a fast-paced environment.
• Able to handle multiple priorities, with excellent attention to detail and commitment to quality.
• Demonstrated service excellence with customers, clients, and co-workers.
• Proven effective and respectful face-face, telephone, and interpersonal communication skills.
• Ability to appropriately resolve issues and escalate when necessary.
• Ability to work collaboratively in a team environment in a positive and professional manner.
• Proven PC proficiency in MS Office applications.
• Demonstrated knowledge of HIPAA rules and regulations.

How We Take Care of Our Team Members

• Remote-first workplace, with opportunities to work on-site in certain locations
• Comprehensive medical, dental, and vision coverage
• Parental leave
• 401K with company match
• Company-paid life insurance, short-term disability, and long-term disability
• Paid time off and holidays

Pay Range: $16.33 - $24.00

This compensation range is a reasonable estimate that extends from the lowest to the highest pay Acclara in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Acclara may ultimately pay more or less than the posted range as permitted by law.

Diversity, Equity, and Inclusion Matter

At Acclara, you’re invited to bring more of yourself to work—not less. Your background, your culture, and your personal experiences are all important pieces of the authentic you, and we honor that. Connection is created when we show up.

Acclara, an R1 company, is dedicated to the fundamentals of equal employment opportunity. Acclara’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, Acclara is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you need reasonable accommodation due to a disability for any part of the interview process, please contact careers@acclara.com.

Visa Sponsorship is not available at this time.