Remote Contract Payment Analyst - Healthcare Reimbursement

St. Luke’s University Health Network; Allentown (Lehigh County); Hybrid; USD 55,000 - 75,000; Full time

Job summary

St. Luke's University Health Network in Allentown, PA is seeking a Contract Payment Analyst to monitor insurance payments, resolve variances and support contract audits within the contract management system.

This full-time role starts with on-site work at the Center in Allentown, with potential remote or hybrid options after training at the manager's discretion for local PA/NJ candidates. The ideal candidate has 3+ years in third-party billing for hospitals or physicians, experience with

Qualifications

• High school diploma / GED required.
• Three years of experience with third party billing for a physician and/or hospital; experience in a centralized billing office preferred.
• Experience with contract management system and Microsoft Suite; data analysis and spreadsheet presentation preferred.

Responsibilities

• The Contract Payment Analyst is responsible for monitoring the accuracy of insurance payments via the variance report and resolving issues.
• Oversees the implant and outlier process to ensure maximum reimbursement.
• Serves as a liaison to our business office and registration staff as well as the payers to improve data accuracy and decrease variances with payments.
• The Contract Analyst is also responsible for the audit of managed care contract terms and changes within the Contract Management system.
• Audit results are tracked and maintained per the contract audit schedule.
• Identifies trends and issues related to underpayments to management for resolution.
• Performs in depth analysis on accounts appearing on variance report to determine cause of variance from expected payment.
• Resolves variances by identifying corrective actions related to under payments, late charges, payer selection issues, posting problems, over payments etc.
• Maintains a variance tracking process that provides issues and resolutions.
• Oversees the no payment expected report to correct errors causing claim to calculate incorrectly.
• Ensure that all implants, carve outs are identified prior to claim submission to allow for appropriate documents and claim information to be completed to facilitate accurate and prompt claim payment.
• Tracks claims submitted with outlier status to ensure appropriate payment received.
• Reviews daily registration report for miscellaneous insurance plan selection to minimize incorrect calculations of reimbursement.
• Provides month end reports to management regarding variance analysis and trending issues and actions.
• Serves as the liaison for registration and payers with regard to communication and resolution of issues.
• Adhere to the contract audit schedule as directed by management and provide feedback for any issues found.

Education

High school diploma / GED

Tools

Microsoft Excel

Job description

St. Luke's University Health Network in Allentown, PA is seeking a Contract Payment Analyst to monitor insurance payments, resolve variances and support contract audits within the contract management system.

This full-time role starts with on-site work at the Center in Allentown, with potential remote or hybrid options after training at the manager's discretion for local PA/NJ candidates. The ideal candidate has 3+ years in third-party billing for hospitals or physicians, experience with