Payment Integrity Analyst – Reimbursement & Contracts

Sanford; United States; On-site; USD 26,000 - 42,000; Full time

Job summary

Sanford Health is seeking a billing analyst to review, maintain, and analyze underpayment records and managed care contracts to ensure reimbursement per contract terms. You will develop procedures, interpret reimbursement rules, and research payor issues to optimize payments.

In this role, you will support billing and finance with analysis, collaborate across departments, and help drive informed decisions in a fast-paced environment. Prior Excel experience is required.

Qualifications

• Associate degree in healthcare or business field required; three years healthcare revenue cycle experience acceptable in lieu of education.
• Experience with Excel spreadsheets required; healthcare revenue cycle experience preferred.

Responsibilities

• Review, maintain, and analyze underpayment records and managed care contracts to ensure payments are made according to contract terms and maximize reimbursement.
• Develop, document and oversee standard operating procedures in One Note to ensure consistency in business rules applied in claim adjudication.
• Identify errors by operational departments and provide guidance on coverage setup; communicate enrollment issues with new payors.
• Support billing and finance in analysis and reporting to aid operational decision making in a fast-paced environment.

Skills

Excel proficiency

Education

Associate degree in healthcare or business field

Tools

Excel

Job description

Sanford Health is seeking a billing analyst to review, maintain, and analyze underpayment records and managed care contracts to ensure reimbursement per contract terms. You will develop procedures, interpret reimbursement rules, and research payor issues to optimize payments.

In this role, you will support billing and finance with analysis, collaborate across departments, and help drive informed decisions in a fast-paced environment. Prior Excel experience is required.