Contract Payment Analyst

St. Luke's University Health Network•Allentown, PA

20h

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Contract Payment Analyst is responsible for monitoring the accuracy of insurance payments via the variance report and resolving issues. Oversees the implant and outlier process to ensure maximum reimbursement. Serves as a liaison to our business office and registration staff as well as the payers to improve data accuracy and decrease variances with payments. The Contract Analyst is also responsible for the audit of managed care contract terms and changes within the Contract Management system. Audit results are tracked and maintained per the contract audit schedule. Identifies trends and issues related to underpayments to management for resolution.

Requirements

High school diploma / GED required.
Three years of experience with third party billing for a physician and/or hospital; experience in a centralized billing office preferred.
Previous experience with a contract management system a preferred.
Previous experience including Microsoft Suite, use of web based applications, analysis of data and presentation with spread sheet completion preferred.

Responsibilities

Performs in depth analysis on accounts appearing on variance report to determine cause of variance from expected payment.
Resolves variances by identifying corrective actions related to under payments, late charges, payer selection issues, posting problems, over payments etc.
Maintains a variance tracking process that provides issues and resolutions.
Oversees the no payment expected report to correct errors causing claim to calculate incorrectly.
Ensure that all implants, carve outs are identified prior to claim submission to allow for appropriate documents and claim information to be completed to facilitate accurate and prompt claim payment.
Tracks claims submitted with outlier status to ensure appropriate payment received.
Reviews daily registration report for miscellaneous insurance plan selection to minimize incorrect calculations of reimbursement.
Provides month end reports to management regarding variance analysis and trending issues and actions.
Serves as the liaison for registration and payers with regard to communication and resolution of issues.
Adhere to the contract audit schedule as directed by management and provide feedback for any issues found.