Sr. Contract Variance Specialist - Business Office - Full Time - Days - 8hr

cvhp; Glendora (CA); On-site; USD 44,000 - 68,000; Full time

Job summary

cvhp seeks a Sr. Contract Variance Specialist to identify payment variances at the account level, interpreting contract terms and applying reimbursement methods for multiple payers.

You will review proration calculations, ensure proper allocation of payments, and support revenue recovery through contract analysis. The role requires 7–10 years in commercial insurance collections, strong Excel skills, and the ability to work independently while collaborating with the Reimbursement Strategy

Qualifications

• High School diploma or equivalent required.
• 7–10 years in commercial insurance collections with claims submission and appeals.
• Strong knowledge of managed care reimbursement methodologies and hospital billing.
• Excellent analytical and communication skills; proficient with MS Office, especially Excel.

Responsibilities

• Identify payment variances at the account level based on contracted payers.
• Review and validate proration calculations and adjustments.
• Analyze underpayments and discrepancies; collaborate with supervisor to resolve issues.
• Support revenue recovery and reimbursement optimization through contract analysis.

Skills

Contract variance analysis

Reimbursement analytics

Payer contract interpretation

Excel proficiency

Education

High School diploma or equivalent

Tools

Excel

Job description

Job Summary

The Sr. Contract Variance Specialist works under the guidance of the Reimbursement Strategy Supervisor and is responsible for identifying payment variances at the account level based on expected reimbursement from contracted managed care payers, governmental payers, and non-contracted miscellaneous payers. This position serves as the contract language expert for multiple payers, ensuring accurate interpretation and application of reimbursement methodologies, contract terms, and payment provisions. The role reviews and validates proration calculations and adjustments, ensuring payments are allocated appropriately and in accordance with payer contracts, regulatory requirements, and organizational policies. The Sr. Contract Variance Specialist analyzes underpayments and identifies proration discrepancies, collaborates with Reimbursement Strategy Supervisor to resolve variance issues, and supports revenue recovery and reimbursement optimization efforts through detailed contract and reimbursement analysis. Ability to quickly learn and adapt to new systems, regulations, and payer requirements.

Job Requirements

Minimum Education Requirement

High School diploma or equivalent required.

Minimum Experience Requirement

Minimum of seven to ten (7–10) years of experience in commercial insurance collections, including claims submission, follow-up, and appeals management. Extensive knowledge of Managed Care reimbursement methodologies and hospital/facility billing processes. Strong understanding of revenue cycle operations, including billing, collections, follow-up, payment posting, and reimbursement processes. Experience interpreting payer contract language and applying various reimbursement and payment methodologies. Demonstrated critical thinking and analytical skills with the ability to identify trends, resolve complex payment issues, and recommend process improvements. Proficient in utilizing multiple billing and payer systems to analyze, compare, and communicate trends, discrepancies, and operational challenges. Advanced proficiency in Microsoft Office Suite, particularly Excel. Excellent customer service, verbal, and written communication skills. Proven ability to work independently with minimal supervision while collaborating effectively in a team environment to achieve organizational goals and ensure optimal reimbursement outcomes.

Minimum License Requirement

None.

Delivering world-class health care one patient at a time.

Pay Range

$32.00 - $48.87