Reimbursement Analyst: Revenue Cycle and Payer Specialist

Connecticut Children's; Connecticut; In loco; USD 60.000 - 90.000; Tempo pieno

Descrizione del lavoro

Connecticut Children’s is seeking a Reimbursement Analyst to analyze incoming payment information and contract terms to ensure timely payment according to agreements. The role supports EPIC HB processes and collaborates with payer representatives, physicians, and patients while upholding CCMC policies.

The candidate should have 3–5 years in healthcare revenue cycle or finance and an Associates degree or equivalent; a Bachelor’s is preferred.

Competenze

• Associates degree or equivalent experience required.
• 3–5 years of healthcare revenue cycle or finance experience.
• Bachelor’s degree preferred.

Mansioni

• Reviews payer payments; researches and resolves hospital payment discrepancies and ensures contractual rates received by way of working Epic work queues.
• Reviews payer policies as communicated.
• Regularly monitors underpaid hospital claims to ensure full resolution.
• Coordinates and leads monthly payer calls including agenda and spreadsheets.
• Identifies HB contract proration issues and documents accordingly.
• Trends proration issues and quantifies for prioritization.
• Manages all HB Payer Variance W/Qs within EPIC.
• Participates in activities to enhance billing and collection efforts related to third party reimbursements.
• Determines whether remaining claim balance should be written off or referred to higher level of management for write-off decision.
• Assists with ad hoc reimbursement requests by utilizing RAD reporting, contracts and fee schedules.
• Other duties as assigned by management.
• Demonstrates cultural sensitivity in all interactions with patients/families and co-workers.
• Demonstrates support for the mission, values and goals of the organization through behaviors that are consistent with the CCMC STANDARDS.

Conoscenze

Analytical skills

Interpersonal communication

Problem-solving

Attention to detail

Organizational skills

Formazione

Associate degree

Bachelor's degree preferred

Strumenti

EPIC HB Reimbursement Contracts

Excel

MS Word

Descrizione del lavoro

Connecticut Children’s is seeking a Reimbursement Analyst to analyze incoming payment information and contract terms to ensure timely payment according to agreements. The role supports EPIC HB processes and collaborates with payer representatives, physicians, and patients while upholding CCMC policies.

The candidate should have 3–5 years in healthcare revenue cycle or finance and an Associates degree or equivalent; a Bachelor’s is preferred.