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SoutheastHEALTH Payer Contract Analyst in Cape Girardeau, Missouri

Payer Contract Analyst

Administrative - Clerical
Cape Girardeau, Missouri

Patient Billing Full-Time

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Description

Day ShiftThe Payer Contract Analyst must have a general understanding of the revenue cycle, understand all payer contracts and be able to identify opportunities to improve overall billing performance, explain variances from estimates and resolve any discrepancies.Begin

  • Act as point of contact for payer contract questions, assisting with billing issues including contacting insurance carriers to confirm patient eligibility and referral information

  • Fully versed in payer contract agreements and billing functions for Acute and Physician Billing, as well as overview of payment policies and administrative rules

  • Conduct performance, variance and financial analysis as assigned.

  • Provide updates that outline under and over payment variances by payer, trend identification and financial performance reporting

  • Review fee schedules and applicable payer rules to ensure correct contract set-up

  • Proactively identify opportunities and key issues to improve payment performance and eliminate false/positive variances within the contract

  • Ensure the contract management software is updated with all relevant fee schedules and/or special contract terms

  • Maintain a tracking report of all payer issues identified, financial impact and ultimate resolution of each issue

  • Review billing forms for accuracy and completeness before sending to payers

  • Creates and maintains training documents specific to payer contracts for billing reference

  • Works with multiple computer software systems simultaneously

  • In collaboration with Director of Patient Financial Services, negotiate contract terms and agreements with payers

  • Maintains positive working relationships with staff, other departments, management and contacts outside the organization

  • Works independently with minimal supervision

  • Performs other duties as assigned

Become

  • High school diploma required

  • Associates degree in Business Administration preferred

  • Previous experience working with payer contract management preferred

  • Excellent attention to detail

  • Must be able to read, write and speak English

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