Revenue Integrity Contract Analyst (Full Time)

Lake Charles Memorial Hospital•Lake Charles, LA

10d•Onsite

About The Position

The Revenue Integrity Contract Analyst collaborates with Epic Information Systems and Health Information Management to extract and analyze account-level reimbursement data, ensuring ongoing accuracy and compliance across all transactions. Reports directly to the Director of Revenue Cycle with a dotted line to the Epic Business Systems Team Lead.

Requirements

Experience with PCs, word processing, spreadsheet, graphics, and database software applications are desired.
Ability to read, write and speak intelligible English.
Strong quantitative, analytical, and organizational skills.
Ability to communicate orally and in written form.
Must be detail oriented.
Requires emotional stability and maturity.
Must be adaptable to change, be decisive, and demonstrate foresight.
Exhibits organizational and leadership ability.
Must be team oriented with strong interpersonal skills.

Nice To Haves

Bachelor Degree or 2-4 year degree (or equivalent working experience) in healthcare related field preferred.
Previous auditing experience preferred.

Responsibilities

Maintains and updates contract fee schedules within Epic, ensuring alignment with payer agreements and organizational standards.
Monitors payer payment patterns and net down trends to identify discrepancies and opportunities for revenue optimization.
Performs thorough contract evaluations and collaborates with Epic Analysts to resolve system-related issues impacting reimbursement.
Proficient in using payment review systems, hospital information systems, and various coding methodologies (e.g., ICD, CPT, HCPCS).
Demonstrates strong ability to interpret medical records, hospital bills, and the charge master for accurate payment analysis.
Understands the operational functions of all ancillary departments to support comprehensive contract and payment reviews.
Effectively negotiates with insurance carrier representatives and customers to resolve payment disputes and secure appropriate reimbursement.
Analyzes managed care contracts and reconciles them against actual payments received to identify underpayments or inconsistencies.
Utilizes internal automation tools and software applications to streamline audit and reconciliation processes.
Successfully identifies and collects underpayments from insurance carriers, contributing to improved revenue recovery.
Accurately documents audit findings and payment discrepancies in the hospital information system to ensure transparency and traceability.
Provides monthly insights and recommendations to leadership aimed at preventing future cash losses and improving financial performance.
Demonstrates the ability to manage multiple projects simultaneously, applying innovation, creativity, and strategic vision to achieve goals.