"Alerted.org

Minimum Hiring Wage:

From $26.89 per hour

Job Details:

Scheduled Hours: Day Shift

Job Description:

A Brief OverviewThe Contract Analyst is responsible for healthcare insurance reimbursement analysis; validating pre-load and post-load of contracts; applying independent judgment in the maintenance of the claims adjudication system; formulating and implementing system improvements; acting as a subject matter expert during contract negotiation processes, making recommendations regarding the terms of the contract; and collaborating with key stakeholders for the resolution of related issues.What you will do

+ Develops and maintains subject matter expertise of Contract module to optimize functionality and reporting. Manages and ensures that all payer contracts built are in accordance with the terms of the contract. Validates contracts once built to review that regulatory and billing guideline are being met. Performs all required maintenance on a timely basis to keep contracts current. Develops collaborative relationships with internal staff to facilitate contract building and discrepancy resolution. Assists with review of Contract Terms and Conditions in a timely manner and makes recommendation for new contract loads.

+ Uses the Billing System modules for generating reports. Performs variance analysis to identify payment discrepancies. Provides data and analysis related to contract performance. Aids in the payment resolution process by accurately documenting and reporting findings. Independently audits and verifies post-contract changes. Communicates with appropriate leadership to ensure discrepancies are resolved. Serves as a liaison between the health system and payer representatives as needed.

+ Responsible for researching and analyzing potential revenue generating ideas and identifying opportunities.

+ Fills out appropriate regulatory paperwork to obtain provider billing numbers for facility credentialing.

+ Serve as the primary liaison between third party payors regarding administration of the contracts. Performs contract modeling and negotiations with third party payors.

Qualifications:

Qualifications

+ Associate’s Degree (AA) Associate’s Degree (AA) Associate degree in health-related field, finance, or equivalent combination of education and experience in a health care Required

+ Bachelor’s Degree in Arts/Sciences (BA/BS) Bachelor’s Degree (AA) Associate degree in health-related field, finance, or equivalent combination of education and experience in a health care Preferred

+ 1-3 years Experience in healthcare billing or reimbursement. Required

+ 4-6 years Experience in healthcare billing or reimbursement. Preferred

+ 1-3 years Experience with patient accounting systems, third party contracts and hospital reimbursement and/or claim payment. Required

+ 1-3 years Prior experience with computer technology Required

+ Knowledge of revenue cycle management and accounting principles effecting reimbursement.

+ Knowledge of contract Module and its impact on other areas of the organization.

+ Ability to gain an understanding of how to accurately interpret contracts and regulations.

+ Ability to master how to design complex contract models in an integrated software environment. Ability to analyze and research payment discrepancies. Ability to accurately analyze fee schedules and run fee comparisons.

+ Ability to research internet and other resources to obtain payment criteria from contracted and government payers.

+ The ability to gain knowledge to accurately complete provider credentialing contracts for selected contracted payers.

+ Excellent interpersonal skills with solid written and oral communication and presentation skills.

+ Proficiency in computer data and analysis

+ Proficiency using Microsoft Office products, Microsoft Excel preferred

+ Solid analytical, quantitative reasoning and problem-solving skills

+ Strong attention to detail and critical thinking skills

+ Work both independently and in team environments/projects

+ Gain/maintain knowledge of applicable regulations, guidelines and policies related to payment variances, including insurance medical/provider policies, and appeals processes

+ Ability to succeed in a high-performance environment where client expectations are consistently met or exceeded

+ Manage time effectively, multi-task and manage competing priorities.

Benefits:

We are excited to offer an aggressive compensation and benefits package for qualifying positions, which includes:

+ Competitive base pay

+ Matching retirement programs

+ Health, Dental and Vision plans

+ Health Savings and Flexible Spending Accounts

+ Employee discounts including car rental, cell-phone plans

+ Employer-paid, Long-Term Disability, Life, and AD&D

+ Paid time off (PTO)

+ Education Assistance Program

+ Employee Assistance Program

+ Employee Referral Bonus Program

+ Discounted cafeteria meals

+ Paid Parental Leave

+ Employee Service Recognition program

+ Voluntary plans including: Life, AD&D, Short-Term Disability, Critical Illness, Accident, Insurance, and Hospital Indemnity

Great River Health and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.