Contract Reimbursement Analayst
About The Position
The Contract Reimbursement Analyst reviews individual patient accounts to ensure accurate contractual reimbursement, reports and appeals improper payments, and generates and monitors system reports to confirm accounts are reimbursed according to contract. The analyst maintains expertise on hospital contracts, presents systemic payer reimbursement issues to Payor Contracting, and identifies and resolves operational issues related to the revenue cycle. The position also supports maintenance of the Contract Management System, including its functionality and data integrity, and regularly prepares high-level summaries of underpayment collection status for executives. This intermediate-level role requires discretion and sound judgment. Work is varied and calls for extensive insurance billing knowledge, organization, prioritization, persistence, workflow analysis, critical thinking, and strong service, interpersonal, customer-service, and phone skills. External contacts include insurance companies, Medicare, and Medicaid. Internal contacts include Revenue Integrity, Payor Contracting, Patient Accounts, Patient Access, Care Management, and Medical Records.
Requirements
- Bachelor’s degree or a combination of education and significant relevant work experience in healthcare.
- At least five years of experience in a healthcare setting.
- Experience with third-party payor contract language and payment methodologies.
- Extensive insurance billing knowledge, organization, prioritization, persistence, workflow analysis, critical thinking, and strong interpersonal, customer-service, and phone skills.
Nice To Haves
- Experience with hospital billing or third-party claims processing.
- Epic experience.
Responsibilities
- Review individual patient accounts for accurate contractual reimbursement.
- Report and appeal improper payments.
- Generate and monitor system reports to review accounts and ensure reimbursement according to contract.
- Maintain expertise on hospital contracts.
- Present systemic payer reimbursement issues to Payor Contracting.
- Identify and resolve operational issues related to the revenue cycle.
- Participate in maintaining the Contract Management System, including overall functionality and data integrity.
- Prepare high-level summaries of underpayment collection status for an executive audience.
Benefits
- Competitive tuition assistance.
- Career development.
- Generous paid time off.
- Code Lavender and Employee Assistance Programs.
- Medical benefits.
- Dental benefits.
- Retirement benefits.
- Paid time off.
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What This Job Offers
Career Level
Mid Level
