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Payer Compliance Analyst

Payer Compliance Analyst

Job ID 
2017-1774
Location 
US-CO-Denver
Metro Area 
Denver, CO
Function 
Revenue Cycle Management
Employment Status 
Full-Time

More information about this job

Overview

USAP-Colorado is a physician-led partnership of anesthesiologists, care team members and practice management experts. Our team of experienced professionals has served this area for more than four decades. We are part of a national network of leading anesthesia providers and have the ability to truly transform anesthesia services across the country. We have access to new resources and best practices that will strengthen our ability to meet the demands of our community. With more than 3,500 team members, USAP is one of the only national companies exclusively dedicated to the practice of anesthesiology. 

 

Responsibilities

Responsibilities of a Payer Compliance Analyst include:

  • Daily analysis of Payer Compliance Module (PCM) contract variances. Analyst will determine if variance is system, operational or payer related and work to research and appropriately resolve each variance.
  • Ensure thorough documentation of all activity taken to resolve variances.
  • Track and trend variance concerns to enhance contract terms and identify payer payment errors. Provide a supporting role in identifying and monitoring changes in payer terms and policies that impact expected payments, work flow, or projected accruals.
  • Resolve payer related variances by working with insurance payer representative, process reconsiderations, first level administrative appeals, and initiate refunds if needed.
  • Initiate correction of operational functions needed to resolve contract variances with other RCM departments, including charge corrections, FSC corrections, and payment posting errors.
  • Assist with maintenance of contract grids for RCM and Finance staff.
  • Maintain RCM communication and SharePoint documents.
  • Assist with PCM updates and onboarding validation.
  • Actively participate in payer education projects and professional development efforts to ensure appropriate management of managed care reimbursement and operational trends.
  • Ensures consistent daily communication with Payer Relations Manager regarding all aspects of assigned projects, to include tracking and trending of system related concerns.
  • Other duties as assigned.

Qualifications

  • College degree is strongly preferred, applicable experience will be considered.
  • Three (3) years of experience working in healthcare business office, billing, or insurance reimbursement.
  • Must be able to manage multiple tasks in a highly-matrixed organization.
  • Exceptionally strong customer service focus.
  • Superb organization and communication skills.
  • Must demonstrate a positive attitude while working within a collaborative team environment.
  • Must maintain a valid unrestricted driver’s license.

 

 

US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.

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