PAYER ANALYTICS SPECIALIST

South Central Regional Medical Center•Laurel, MS

About The Position

The Payer Analytics Specialist reports to the Patient Accounts Director and provides reporting and analysis related to payer reimbursement trends, denials, and revenue cycle performance. This role supports data-driven decision-making through detailed payer analysis, trend identification, and collaboration with revenue cycle stakeholders to improve reimbursement outcomes.

Requirements

High school diploma or GED required
One year experience in hospital or professional billing, medical coding, or healthcare registration preferred
Ability to type at least 30 WPM
Demonstrated verbal and written communication skills
Knowledge of insurance billing procedures and medical terminology
Strong attention to detail
Ability to manage multiple tasks
Proficiency in Microsoft Office
Experience with billing software preferred
Strong organizational and time-management skills
Ability to maintain confidentiality and comply with HIPAA
Knowledge of ICD-10, CPT/HCPCS, medical necessity guidelines
Strong analytical and problem-solving skills
Ability to interpret payer policies and contractual language

Nice To Haves

Associate’s or Bachelor’s degree preferred
One year experience in hospital or professional billing, medical coding, or healthcare registration preferred
Experience with billing software preferred

Responsibilities

Research and analyze insurance claim denials, ADR requests, recoupments, and underpayments
Utilize EMR and clearinghouse analytics tools
Identify trends and provide monthly and quarterly reports
Collaborate with admissions, billing, coding, administration, and provider liaisons
Submit and track appeals
Respond to payer and RAC audit requests
Maintain payer reference materials
Assist with special projects and complex billing issues
Maintain current knowledge of government and commercial payors
Track denial trends, perform root cause analysis, and recommend process improvements