Payment Compliance & Contract Management Analyst

Tennova Healthcare- North Knoxville Medical Center; United States; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health coverage

401(k) with matching

Student loan assistance (up to $10,000

Tuition assistance

Competitive pay & full benefits

Job summary

Community Health Systems (CHS) is seeking a Payment Compliance & Contract Management (PCCM) Analyst to maximize reimbursement by analyzing variances between posted and expected revenue across managed care, government contracts, and other payers.

The role collaborates with financial and clinical teams to improve revenue cycle processes, identify opportunities, and communicate discrepancies for process enhancement. Strong data analysis and medical coding knowledge are essential.

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.

Responsibilities

• Analyzes contract reimbursement, identifying variances and revenue leakage to maximize reimbursement.
• Manages underpayment appeals and follow-up with payers and internal teams.
• Interprets contract terms, validates compliance, and provides feedback to ensure accurate reimbursement processes.
• Compiles, analyzes, and presents data on payment trends to improve revenue cycle processes.
• Reviews payer policies for impact on reimbursement and communicates changes to teams.

Skills

Managed care

Government contracts

Reimbursement processes

Data analysis

Excel

Communication

Medical coding (ICD-10)

Medical coding (CPT/HCPCS)

DRG

Google Workspace

Microsoft Office

Education

H.S. Diploma or GED

Associate degree or higher preferred

Tools

None

Job description

• Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.
• Future Security: 401(k) with matching
• Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.
• Educational Tuition Assistance
• Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.

Benefits

• Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.
• Future Security: 401(k) with matching
• Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.
• Educational Tuition Assistance
• Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.

Job Summary

The Payment Compliance & Contract Management (PCCM) Analyst 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.
• Maintains regular and reliable attendance.
• 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.

Team Overview

The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.

Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.