Payment Variance Analyst

November 3

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Med-Metrix

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Revenue Cycle Management • Business Intelligence • Revenue Recovery • Managed Care Improvement • Physician Advisor Services

1001 - 5000

💰 Private Equity Round on 2021-09

Description

• The Payment Variance Analyst will identify opportunities to pursue additional reimbursement due to contractual payment discrepancies. • This role will make use of managed care contracts to determine appropriate rates, provisions and terms are being followed by the payers. • The Payment Variance Analyst will report any root causes for the discrepancies identified to the manager. • Perform payment variance analysis to identify trends in underpaid claims. • Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results. • Identify and report underpayments and denial trends. • Initiate appeals when necessary. • Analyze, identify and resolve issues causing payer payment delays including billing and coding errors. • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties. • Report any security or HIPAA violations or concerns to the HIPAA Officers in a timely fashion.

Requirements

• 2 years’ experience in Commercial insurance collections, including submitting and following up on claims • 2 years’ experience of underpayment analyst experience • Detailed knowledge of Managed Care reimbursement methodologies • Experience in Hospital/Facility billing • Ability to adapt to learning a wide range of systems and regulations • Ability to work well individually and in a team environment • Proficiency with MS Office • Strong communication skills, including oral and written • Strong organizational skills