Revenue Recovery and Contract Analyst

Austin Regional Clinic - Austin, TX

Full-time - Entry Level

Austin, TX

11-50 employees

Ambulatory Health Care Services

About the position

The Revenue Recovery and Contract Analyst is responsible for reviewing, coordinating, and appealing denied and underpaid claims within the healthcare sector. This role involves preparing appeals, discussing denials with payer representatives, and monitoring follow-up activities while ensuring patient confidentiality. The analyst will also conduct financial impact analyses of contract negotiations, interpret managed care contract terms, and manage accounts receivable processes to optimize revenue recovery.

Responsibilities

• Review and coordinate appeals for denied and underpaid claims.
• Prepare appeal letters and discuss denials with payer representatives.
• Monitor outcomes of follow-up activities related to claims.
• Complete financial impact analysis of contract negotiations and present recommendations to leadership.
• Interpret managed care contract terms and validate contract models.
• Review Managed Care contracts and amendments to ensure accuracy.
• Evaluate underpayments and overpayments for potential recovery opportunities.
• Generate and submit individual or mass appeals and track their progress.
• Communicate payer contracting issues to management and prepare monthly reports.
• Identify and escalate consistent issues with payers to support leadership in resolving them.

Requirements

• High school diploma or equivalent.
• At least 5 years of experience with Epic billing, claim denial management, and registration modules.
• At least 2 years of experience in accounts receivable, effectively pursuing payments from carriers and customers.

Nice-to-haves

• Experience with CMS/ARC billing & collections functions.
• Knowledge of billing and collecting from Medicare, Medicaid, and Commercial Insurance.
• Basic knowledge of insurance contracts and fee schedules.
• Knowledge of procedural and diagnostic coding.

Benefits

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance