Payment Compliance Analyst - REMOTE

Remote Jobs; Franklin (TN); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare provider in Franklin, Tennessee, seeks a Revenue Cycle Analyst to maximize reimbursement through analysis and compliance. The ideal candidate has experience in revenue cycle management, strong data analysis skills, and proficiency with Excel. This role offers a robust benefits package and opportunities for career advancement within a collaborative environment.

Benefits

Robust benefits package

Career advancement opportunities

Collaborative work environment

Qualifications

• 2-4 years of experience in revenue cycle management, contract compliance, or healthcare reimbursement analysis required.
• Strong understanding of managed care, government contracts, and reimbursement processes.
• Proficiency in data analysis, with the ability to compile and interpret complex data sets.

Responsibilities

• Analyze contract reimbursement, identifying variances and trends.
• Manage underpayment appeals and collaborate with payers to resolve discrepancies.
• Compile, analyze, and present data on payment trends.

Skills

Data analysis

Excellent communication

Interpersonal skills

Understanding of managed care

Education

H.S. Diploma or GED

Associate Degree or higher

Tools

Excel

Google Suite

Microsoft Office Suite

Job description

Employer Industry: Healthcare Provider

Why consider this job opportunity:

• Robust benefits package including medical, dental, vision insurance, and 401k
• Opportunity for career advancement and professional development within the organization
• Engage in meaningful work that supports the health and wellness of communities
• Collaborative work environment with a focus on improving revenue cycle processes
• Chance to work with a leading healthcare provider with a commitment to quality care

What to Expect (Job Responsibilities):

• Analyze contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and revenue leakage to maximize reimbursement
• Manage underpayment appeals and collaborate with payers and internal teams to resolve discrepancies promptly
• Interpret contract terms and validate compliance to ensure accurate reimbursement processes
• Compile, analyze, and present data on payment trends, recommending improvements in revenue cycle processes
• Maintain knowledge of medical coding systems and reimbursement structures to support accurate account adjudication

What is Required (Qualifications):

• H.S. Diploma or GED required
• 2-4 years of experience in revenue cycle management, contract compliance, or healthcare reimbursement analysis required
• Strong understanding of managed care, government contracts, and reimbursement processes
• Proficiency in data analysis, with the ability to compile and interpret complex data sets
• Excellent communication and interpersonal skills for collaboration with internal teams and external payer representatives

How to Stand Out (Preferred Qualifications):

• Associate Degree or higher preferred
• Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG, etc.) and their impact on claim adjudication
• Strong organizational skills, able to manage multiple projects and deadlines
• Proficient in Google and Microsoft Office Suite, with intermediate to advanced Excel skills

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