Contract Management Analyst

Care New England Health System • Warwick, RI

2d

About The Position

Under the direction of the A/R Supervisor, the Contract Management Analyst reviews and analyzes payment variances and determines corrective action. The role analyzes payments received from third-party payers and researches and corrects underpayments and overpayments according to established payer contracts. It serves as a billing liaison to patients, providers, insurance carriers, and internal and external customers to help ensure appropriate claim reimbursement.

Requirements

• High school degree required.
• A minimum of 3–5 years of previous experience in a healthcare or business environment.
• Excellent human relations, communication, and organizational skills.
• Working knowledge of computer applications, including word processing, spreadsheet, and database applications.
• Knowledge of third-party payers and collection policies and procedures.
• Excellent analytical, oral, and written skills, with the ability to communicate and collaborate with agencies and internal and external customers.

Nice To Haves

• Associate degree preferred.

Responsibilities

• Review variances, follow up on remaining balances due, and establish follow-up protocols to initiate claim adjustments for additional reimbursement.
• Review overpayments and pursue recovery so overpaid accounts are recouped or refunded by the third-party payer in a timely manner.
• Use information-system tools to document, report, and analyze accounts receivable.
• Initiate corrected claims as needed to resolve underpaid or overpaid accounts.
• Provide supporting documentation as needed to appeal variances in a timely manner.
• Initiate adjustment requests to correct false variances in the contract management system.
• Analyze payment discrepancies, determine their root cause by payer, facility coding, or system setup, and inform the supervisor when escalation is needed.
• Apply knowledge of accounts receivable payment policies and hospital contracts related to billing, collection, follow-up, claim reimbursement, patient liability, and local, state, and federal programs.
• Document account history accurately in appropriate computer systems within defined time frames and in accordance with department policies and procedures.
• Respond to email, telephone calls, and other correspondence daily in accordance with department policies and procedures.
• Preserve and protect patients' rights to confidentiality.
• Perform other related duties as requested.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED