Contract Payment Analyst (Full Time, Days)

St. Luke’s Health Network, Inc.; Allentown (Lehigh County); Hybrid; USD 55,000 - 75,000; Full time

Job summary

St. Luke's University Health Network is seeking a Contract Payment Analyst to monitor insurance payments, resolve variances, and collaborate with the business office and payers to improve data accuracy.

The role emphasizes detailed analysis of claim payments, contract terms, and timely communication with stakeholders. The position offers full-time hours with potential for remote or hybrid work after training, based on manager discretion and local eligibility in PA/NJ.

Qualifications

• Three years of experience with third party billing for a physician and/or hospital.
• Knowledge of commercial payors is preferred, but not mandatory.
• Experience with contract management systems and data analysis is beneficial.

Responsibilities

• Performs in-depth analysis on accounts on the variance report to determine cause of variance from expected payment.
• Resolves variances by identifying corrective actions related to underpayments, late charges, and payer issues.
• Maintains a variance tracking process with issues and resolutions.
• Oversees the no payment expected report to correct errors causing claims to calculate incorrectly.
• Audits managed care contract terms and changes within the Contract Management system.
• Provides month-end reports to management regarding variance analysis and trends.

Skills

Third-party billing

Payer knowledge

Data analysis

Education

High school diploma / GED

Tools

Microsoft Suite

Job description

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 occasionally 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.