Payer Provider Engagment Anlayst

Legacy Health•Portland, OR

2d•$41 - $61•Hybrid

About The Position

This is a hybrid role that is open to candidates working from Oregon or Washington. Team members typically work 2-3 days per week onsite at a Legacy Health location, with the remainder of the workweek completed from a virtual location (in Oregon or Washington). All new hires are required to travel to a Legacy Health office in Portland, Oregon prior to their start date to complete a new hire health assessment and new hire paperwork. Initial training and orientation may be conducted on-site before transitioning to the hybrid schedule. The Payer Provider Engagement Analyst serves as a liaison between the organization and its payers. This role is responsible for compiling payer data, understanding health plan requirements around billing, documentation, authorization, processes, policy changes, and more, and educates Legacy Health staff about these requirements. This role is also responsible for analyzing trends around payer denials and outstanding A/R, and working with internal departments, as well as external payers, to resolve identified issues.

Requirements

Bachelor’s Degree in Business, Healthcare Administration, Information Systems, Computer Science or equivalent degree OR equivalent experience.
Five years of experience in healthcare billing, follow-up, or denials management required.
Minimum of three years’ experience in payer contracting or payer relations management required.
Prior hospital or health care experience with emphasis on workflow and procedures, operations management, financial management and reimbursement issues required.
Quality Assurance, project management, and leadership experience required.
Ability to promote/support management with payer relations, A/R management, and insurance plan requirements.
Development and maintenance of reports by payer and plan level detail (e.g. Trends, action plans).
In-depth knowledge of payer requirements.
Strong analytical skills and experience with various analytic and reporting solutions.
Strong interpersonal skills, including excellent written and verbal communications.
Ability to effectively communicate with various levels of staff, both internally and externally.
Strong understanding of healthcare billing, follow-up, and denials management processes and systems.

Nice To Haves

Master’s degree preferred.

Responsibilities

Serves as a liaison between the organization and its payers.
Compiles payer data.
Understands health plan requirements around billing, documentation, authorization, processes, policy changes, and more.
Educates Legacy Health staff about payer requirements.
Analyzes trends around payer denials and outstanding A/R.
Works with internal departments and external payers to resolve identified issues.