Payment Compliance Analyst - REMOTE

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

Job summary

A leading company in IT Services is seeking a Payment Compliance & Contract Management Analyst to maximize reimbursement and manage contracts. The role involves analyzing financial data, managing discrepancies, and collaborating with various teams to optimize revenue processes. Ideal candidates will have experience in revenue cycle management and strong analytical skills.

Qualifications

• 2-4 years of experience in revenue cycle management or healthcare reimbursement analysis required.
• Strong understanding of managed care and reimbursement processes.
• Proficiency in data analysis and interpreting complex data sets.

Responsibilities

• Analyzes contract reimbursement and identifies variances related to revenue.
• Manages underpayment appeals and collaborates with internal teams.
• Develops and maintains reports on payment discrepancies and revenue opportunities.

Skills

Data analysis

Communication

Organizational skills

Education

H.S. Diploma or GED

Associate Degree or higher

Tools

Google Suite

Microsoft Office Suite

Excel

Job description

18 hours ago Be among the first 25 applicants

Lensa is a U.S. career site that helps job seekers discover job opportunities. We are not a staffing firm or agency. We promote jobs on behalf of our clients, which include employers, recruitment agencies, and marketing partners.

Job Summary

The Payment Compliance & Contract Management (PCCM) Analyst - REMOTE is responsible for maximizing reimbursement by identifying variances between posted and expected revenue for managed care, government contracts, and other payers. This role includes analyzing contract compliance, identifying revenue opportunities, and communicating discrepancies to relevant departments. The PCCM Analyst collaborates with financial and clinical teams to improve revenue cycle processes and optimize payer relationships.

Essential Functions

• Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and revenue leakage to support maximization of reimbursement.
• Manages underpayment appeals and account follow-up, working collaboratively with payers and internal teams to resolve discrepancies in a timely manner.
• Interprets contract terms, validates compliance, and provides feedback to management and departments to ensure accurate reimbursement processes.
• Compiles, analyzes, and presents data on payment trends, making recommendations for improvements in revenue cycle processes.
• Reviews payer policies and updates for their impact on reimbursement, communicating changes to appropriate teams to ensure compliance.
• Develops and maintains reports that identify payment discrepancies, revenue opportunities, and performance metrics for management review.
• Collaborates with financial, clinical, and operational teams to address contract compliance issues and enhance payer relations.
• Maintains knowledge of medical coding systems, reimbursement structures, and regulatory changes to support accurate account adjudication.
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Qualifications

• H.S. Diploma or GED required
• Associate Degree or higher preferred
• 2-4 years of experience in revenue cycle management, contract compliance, or healthcare reimbursement analysis required
  
  

Knowledge, Skills And Abilities

• Strong understanding of managed care, government contracts, and reimbursement processes.
• Proficiency in data analysis, with the ability to compile and interpret complex data sets related to contract compliance and payment trends.
• Excellent communication and interpersonal skills for working with internal teams and external payer representatives.
• Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG, etc.) and how they affect claim adjudication.
• Strong organizational skills, with the ability to manage multiple projects and deadlines.
• Proficient in Google and Microsoft Office Suite, with intermediate to advanced Excel skills.
  
  

Equal Employment Opportunity

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Legal

• Industries

  IT Services and IT Consulting

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