Jobs at Trend Health Partners

Owns the product backlog and translates user needs into JIRA tickets, user stories, and acceptance criteria. Partners with Product Management, Engineering, QA, and cross-functional stakeholders on prioritization, release planning, testing, and delivery. Monitors feature adoption, gathers feedback, advocates for end users, and supports business cases and ROI analysis. The role requires understanding healthcare workflows and facilitating communication among technical and business teams.

Researches and analyzes healthcare claims to identify, validate, and recover overpayments for commercial insurers and state healthcare programs. Reviews contracts, payment policies, claims systems, algorithms, and regulatory guidance; resolves disputed overpayments; develops and documents new recovery opportunities; and collaborates with management, clients, providers, and team members to ensure accurate, timely claim analysis and continuous process improvement.

Reviews hospital claims, remittances, EOBs, and payer correspondence to identify underpayments and incorrect adjudications. Interprets contracts and reimbursement methodologies, initiates corrected claims, prepares appeals, follows up with payers, and tracks recoveries. Identifies systemic payment trends, documents cases, collaborates with clients and internal teams, and meets accuracy, recovery, and turnaround KPIs.

Analyzes and recovers healthcare claim overpayments by validating claims, reviewing disputes, researching payer policies, and coordinating adjustments, refunds, and offsets with providers. The role interprets medical, pharmacy, provider, and enrollment data to identify recovery trends and opportunities, supports algorithm development and production documentation, monitors performance, and collaborates with payers, providers, management, and team members.