Hospital Reimb Contract Analyst - Corp Revenue Integrity - Full Time

Guthrie

Full-time - Mid Level

251-500 employees

Hospitals

About the position

The Hospital Reimb Contract Analyst is responsible for coordinating processes related to third-party contract management within the healthcare sector. This role involves conducting audits, monitoring payor performance, analyzing billing and collection data, and developing management reports. The analyst must adapt to the current in-house billing system and ensure compliance with third-party billing regulations.

Responsibilities

• Create reimbursement rules (contract profiles) within the current in-house billing system and maintain them to reflect new or updated contracts.
• Participate in payor contract meetings and discussions regarding third-party payor performance issues.
• Monitor insurance payments and identify variances from negotiated contract rates, communicating with insurance companies as needed.
• Conduct quarterly third-party performance audits and prepare audit reports and support documentation.
• Prepare comprehensive Monthly Revenue Cycle Management Reports and other necessary reporting to support revenue cycle operations.
• Conduct bi-annual contract education for the CRC staff regarding payor contracting and performance training.
• Complete the Medicare Bad Debt Log for submission with the Medicare Cost Report.
• Prepare and submit the quarterly Medicare Credit Balance Report for Corning Hospital.

Requirements

• Minimum of five (5) years in the health care accounts receivable field with proven leadership capabilities.
• Bachelor's Degree in Accounting, Business Administration, or a relevant program required.
• Three (3) years of experience analyzing financial data and developing management reports.
• Significant experience in managing health care financial data may substitute for degree requirements.
• Knowledge of Microsoft products and working knowledge of electronic health and financial record systems is required.

Nice-to-haves

• An associate degree in Business Administration or related field is preferred.
• High school graduate with five (5) years of proven practical experience in the health care accounts receivable field.

Benefits

• Diversity and inclusion in the workplace.
• Opportunities for professional development and growth.