Payer Contract Analyst

Summit Orthopedics•Woodbury, MN

1d•$67,811 - $84,764•Onsite

About The Position

Under the direct supervision of the Manager of Financial Planning & Analysis, the Payer Contract Analyst will be responsible for interpreting, modeling, maintaining and monitoring payer contract reimbursement terms. The role will partner with Revenue Cycle, Operations and Finance to ensure payer contracts are accurately represented in contract management system and that payments align with contractual intent.

Requirements

Interpreting, modeling, maintaining and monitoring payer contract reimbursement terms
Partnering with Revenue Cycle, Operations and Finance to ensure payer contracts are accurately represented in contract management system and that payments align with contractual intent
Serving as System Administrator of Strata Decision Technology’s Contract Analytics platform
Building and maintaining reimbursement models for payer contracts
Translating contract language into expected reimbursement logic
Analyzing payer proposals or policy changes and modeling financial impact
Supporting payer rate negotiations, contract renewals and underpayment audit process
Validating expected reimbursement calculations against actual payments and monitoring for compliance or issue escalation
Assessing Price Transparency data and assisting with ensuring Summit is compliant with regulations
Preparing contract performance reports and payer scorecards
Performing Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for place of service
Preparing ad hoc reports and analysis, and performing other duties, as assigned

Responsibilities

Serves as System Administrator of Strata Decision Technology’s Contract Analytics platform
Builds and maintains reimbursement models for payer contracts
Translates contract language into expected reimbursement logic
Analyzes payer proposals or policy changes and models financial impact
Supports payer rate negotiations, contract renewals and underpayment audit process
Validates expected reimbursement calculations against actual payments and monitors for compliance or issue escalation
Assesses Price Transparency data and assists with ensuring Summit is compliant with regulations
Prepares contract performance reports and payer scorecards
Performs Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for place of service
Prepares ad hoc reports and analysis, and performs other duties, as assigned