Trend Health Partners Benefits Overview

Analyzes healthcare claims, provider, pharmacy, and enrollment data to identify trends, improve data quality, optimize workflows, reduce costs, and support business decisions. Translates business needs into requirements, develops complex SQL queries, validates data, recommends process improvements, coordinates projects, and serves as a liaison among operations, research and development, IT, and external partners. Also mentors team members and communicates technical findings to nontechnical stakeholders.

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.