Contract Management Analyst

Care New England; Warwick (RI); On-site; USD 65,000 - 90,000; Full time

Job summary

Care New England Health System seeks a Contract Management Analyst in Rhode Island to review variances, analyze payments from third party payers, and determine corrective actions. The role acts as a billing liaison with patients, providers, and insurers to ensure appropriate reimbursement on claims.

The position emphasizes documentation, accurate account history updates, and timely response to inquiries. A strong background in healthcare billing and contracts supports success in this role.

Qualifications

• Minimum 3–5 years of experience in a healthcare or business environment.
• Excellent communication and organizational skills.
• Knowledge of third party payers and collection policies.
• Strong analytical, oral and written communication abilities.

Responsibilities

• Review variances and follow up on remaining balance due; establish follow up protocol.
• Process overpayment recovery to recoup refunds from third party payers.
• Document and analyze accounts receivable using information systems.
• Initiate corrected claims to resolve under- or overpaid accounts.
• Provide supporting documentation to appeal variances timely.
• Initiate adjustment requests to rectify false variances in the system.
• Identify root causes by payer, facility coding, or system setup and inform supervisor.

Skills

Communication

Organizational skills

Analytical skills

Attention to detail

Oral communication

Written communication

Education

High school diploma

Associate degree

Tools

MS Word

MS Excel

Database applications

Job description

Job Summary

Under the direction of the A/R Supervisor, The Contract Management Analyst will review and analyze all variances and determine corrective action. Responsible for analyzing payments received from third party payers. Researching and correcting any under or over payments per the established payer contracts. The Contract Management Analyst functions as a billing liaison to patients, providers, and insurance carriers, internal and external customers to ensure appropriate reimbursement on claims.

Duties & Responsibilities

• Review variances and follow up on remaining balance that is due. Establish follow up protocol to initiate claim adjustment for additional reimbursement.
• Review variances and proceed with overpayment recovery process to ensure that accounts that are overpaid are recouped/ refunded in a timely manner by the third party payer.
• Utilizes information system tools to document, report and analyze the accounts receivable.
• Initiate corrected claims as necessary to resolve under or over paid accounts.
• Provide supporting documentation as needed to appeal variances in a timely manner.
• Initiate adjustment requests to rectify false variances in the contract management system.
• Analyze payment discrepancies and determine the root cause by payer, facility coding or system setup and inform supervisor to elevate as needed.
• Demonstrates knowledge of accounts receivable payment policies and hospital contracts as they relate to billing, collection, follow-up, claim reimbursement, patient liability, and local, state and federal programs.
• Accurately documents account history in appropriate computer systems within defined time frames in accordance with department policies and procedures.
• Respond to email, telephone calls and other correspondence on a daily basis in accordance with department policy and procedures.
• Preserves and protects patient's rights to confidentiality.
• Performs other related duties as requested.

Requirements

• High school degree required.
• Associates degree preferred.
• Minimum of 3-5 years of previous experience in a healthcare or business environment.
• Excellent human relations, communication, and organizational skills required.
• Working knowledge of computer applications, including word processing, spreadsheet, and database applications required.
• Knowledge of third party payers and collection policies and procedures required.
• Excellent analytical, oral and written skills with the knowledge and ability to communicate and collaborate with agencies and internal and external customers required.

About Us

Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation's top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. Care New England is helping to transform the future of health care, providing a leading voice in the ongoing effort to ensure the health of the individuals and communities we serve.

EEO Statements

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.