Revenue Cycle Payer Relations Analyst

University of Miami - Medley, FL

Full-time - Mid Level

Medley, FL

Educational Services

About the position

The Revenue Cycle Payer Relations Analyst at the University of Miami is responsible for analyzing and improving processes within the Revenue Cycle Department. This role focuses on developing and maintaining relationships with payers, providing expert analysis of reimbursement data, and collaborating with internal staff to resolve revenue-related issues. The analyst will monitor payer trends, ensure compliance with managed care contracts, and manage accounts receivable effectively.

Responsibilities

• Perform analysis and develop performance improvements within the Revenue Cycle Department.
• Develop and maintain excellent relations with payers and serve as an expert resource for payer policies.
• Provide accurate and complex data analysis of reimbursement for all payers.
• Develop recommendations for optimal managed care reimbursement.
• Collaborate with internal staff to resolve issues related to the revenue stream.
• Analyze and monitor payer trends and managed care contract compliance.
• Perform accurate and timely accounts receivable management.
• Analyze accounts receivable transactions for compliance with internal controls and accounting policies.
• Maintain and reconcile accounts receivable ledger and prepare management reports.
• Analyze trends in bad debts and recommend improvements to accounts receivable policies and procedures.
• Coordinate with departments and insurance companies to correct errors as necessary.
• Document and track all revenue cycle payer issues.
• Lead payer contract loads for underpayment recovery.
• Conduct analysis and outcome assessments on issue reports.
• Communicate changes and prepare weekly reports for Revenue Cycle leadership.
• Maintain documentation for the Payer Relations Team within Revenue Cycle.
• Coordinate payer visits to learn about portal enhancements and updates.
• Assist with payer in-service training upon request.
• Audit proper use of account resolution from identification stage through resolution.
• Monitor reimbursement regulations and maintain knowledge of current legislation concerning HMO appeals.
• Participate in management and other meetings as necessary.
• Attend payer JOC meetings and represent the organization at statewide payer teleconference meetings.

Requirements

• Associate degree in relevant field.
• Minimum 5 years of relevant experience.
• HFMA CRCR Certification Required.
• Ability to exercise sound judgment in making critical decisions.
• Skill in completing assignments accurately and with attention to detail.
• Ability to analyze, organize and prioritize work under pressure while meeting deadlines.
• Ability to work independently and/or in a collaborative environment.
• Ability to communicate effectively in both oral and written form.
• Ability to maintain effective interpersonal relationships.
• Proficiency in computer software (i.e., Microsoft Office).
• Any appropriate combination of relevant education, experience and/or certifications may be considered.

Benefits

• Competitive salaries
• Comprehensive benefits package including medical and dental insurance
• Tuition remission