Payment Compliance & Contract Management Analyst

Community Health Systems

United States

On-site

USD 65,000 - 90,000

Full time

4 days ago

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Benefits offered by this job

Health coverage

401(k) matching

Student loan support

Tuition assistance

Competitive pay

Full benefits

Job summary

Community Health Systems is seeking a Payment Compliance & Contract Management Analyst to optimize reimbursement across managed care contracts and government payers. The role analyzes variances, supports appeals, and collaborates with finance and clinical teams to improve revenue cycle processes.

Responsibilities include tracking payment trends, updating policies, and presenting actionable insights to leadership.

Qualifications

2–4 years of experience in revenue cycle management, contract compliance, or healthcare reimbursement analysis.
HS diploma or GED required; associate degree preferred.
Strong data analysis and communication skills with payer liaison experience.

Responsibilities

Analyze contract reimbursement and identify variances, and revenue leakage to maximize reimbursement.
Manage underpayment appeals and follow up with payers and internal teams.
Interpret contract terms, validate compliance, and provide feedback to ensure accurate reimbursements.
Compile and present data on payment trends and opportunities for revenue cycle improvement.
Monitor payer policies and communicate changes to relevant teams for compliance.
Develop and maintain reports on discrepancies, opportunities, and performance metrics.
Collaborate with financial, clinical, and operational teams to address contract issues.

Skills

Data analysis

Communication skills

Organizational skills

Payer relations knowledge

Education

HS Diploma or GED

Associate degree or higher preferred

Tools

Google Workspace

Microsoft Office Suite

Microsoft Excel

Job description

Payment Compliance & Contract Management Analyst

United States

Trending

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.

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.

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.

Job Info