Contract Payment Analyst (Full Time, Days)

St. Luke's University Health Network; Allentown (Lehigh County); Hybrid; USD 34.000 - 48.000; Vollzeit

Zusammenfassung

St. Luke’s University Health Network is seeking a Contract Payment Analyst to monitor insurance payments, analyze variances and support maximum reimbursement. You will work with the business office, registration staff and payers to improve data accuracy and reduce underpayments.

The role requires attention to detail, experience with third-party billing and familiarity with contract management processes. Training provided; remote or hybrid work may be available for local candidates after training.

Qualifikationen

• Three years of experience with third party billing for a physician and/or hospital.
• Experience with a contract management system preferred.
• Experience including Microsoft Suite, web-based applications, data analysis and spreadsheet presentation preferred.

Aufgaben

• Performs in depth analysis on accounts appearing on variance report to determine cause of variance from expected payment.
• Resolves variances by identifying corrective actions related to under payments, late charges, payer selection issues, posting problems, over payments etc.
• Maintains a variance tracking process that provides issues and resolutions.
• Oversees the no payment expected report to correct errors causing claim to calculate incorrectly.
• Ensure that all implants, carve outs are identified prior to claim submission to allow for appropriate documents and claim information to be completed to facilitate accurate and prompt claim payment.
• Tracks claims submitted with outlier status to ensure appropriate payment received.
• Reviews daily registration report for miscellaneous insurance plan selection to minimize incorrect calculations of reimbursement.
• Provides month end reports to management regarding variance analysis and trending issues and actions.
• Serves as the liaison for registration and payers with regard to communication and resolution of issues.
• Adhere to the contract audit schedule as directed by management and provide feedback for any issues found.

Kenntnisse

Variance analysis

Third-party billing

Data analysis

Microsoft Excel

Ausbildung

High school diploma or GED

Tools

Contract management

Web-based applications

Jobbeschreibung

St. Luke’s is proud of the skills, experience and compassion of its employees. The employees of St. Luke’s are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient’s ability to pay for health care.

HOURS:

Full Time, Days, 40 hours/week

Mon-Fri

No nights, holidays, or weekends

Flexible start times from 7 AM - 8:30 AM

Home location is St. Luke’s Center in Allentown PA, with the opportunity to request remote or hybrid work, after training & at the manager’s discretion, for local (PA, NJ) candidates only.

This role is for hospital contract analyst. Knowledge of commercial payors is preferred,but not necessarily mandatory.

The Contract Payment Analyst is responsible for monitoring the accuracy of insurance payments via the variance report and resolving issues. Oversees the implant and outlier process to ensure maximum reimbursement. Serves as a liaison to our business office and registration staff as well as the payers to improve data accuracy and decrease variances with payments. The Contract Analyst is also responsible for the audit of managed care contract terms and changes within the Contract Management system. Audit results are tracked and maintained per the contract audit schedule. Identifies trends and issues related to underpayments to management for resolution.

JOB DUTIES AND RESPONSIBILITIES:

• Performs in depth analysis on accounts appearing on variance report to determine cause of variance from expected payment.
• Resolves variances by identifying corrective actions related to under payments, late charges, payer selection issues, posting problems, over payments etc.
• Maintains a variance tracking process that provides issues and resolutions.
• Oversees the no payment expected report to correct errors causing claim to calculate incorrectly.
• Ensure that all implants, carve outs are identified prior to claim submission to allow for appropriate documents and claim information to be completed to facilitate accurate and prompt claim payment.
• Tracks claims submitted with outlier status to ensure appropriate payment received.
• Reviews daily registration report for miscellaneous insurance plan selection to minimize incorrect calculations of reimbursement.
• Provides month end reports to management regarding variance analysis and trending issues and actions.
• Serves as the liaison for registration and payers with regard to communication and resolution of issues.
• Adhere to the contract audit schedule as directed by management and provide feedback for any issues found.

PHYSICAL AND SENSORY REQUIREMENTS:

Sitting for prolonged periods, up to 4 hours, with occasional twisting or turning. Repetitive motions of hands for data entry, Lifting occasions of up to 10 lbs. Reaching, bending or stooping to retrieve documents. Normal hearing and visual skills. Visual monotony from computer screen reading.

EDUCATION:

High school diploma / GED required.

TRAINING AND EXPERIENCE:

Three years of experience with third party billing for a physician and/or hospital; experience in a centralized billing office preferred.Previous experience with a contract management system a preferred.Previous experience including Microsoft Suite, use of web based applications, analysis of data and presentation with spread sheet completion preferred.

St. Luke’s University Health Network is an Equal Opportunity Employer.