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Payor Compliance Lead

Payor Compliance Lead

Job ID 
2018-1852
Location 
US-FL-Maitland
Metro Area 
..
Function 
Revenue Cycle Management
Employment Status 
Full-Time

More information about this job

Overview

U.S. Anesthesia Partners (USAP) is the largest single-specialty anesthesia practice in the country with over 4,000 clinical providers and associates.  By joining our team you will participate in a highly collaborative and dynamic environment.  As an organization we are mission focused on delivering the highest quality in patient care and you will be directly supporting our talented clinical team.  We extend this same commitment to quality to our associates and supply tools and resources that will ensure we win in the healthcare marketplace and support of USAP.

 

We are proud of our inclusive people culture that supports our associates to perform at their best.  USAP is an equal opportunity employer.  Candidates with physician services or related health care experience is a plus. We offer a competitive benefits package. 

 

U.S. Anesthesia Partners of Florida is seeking a Payer Compliance Analyst to work in our Regional office located in Maitland, Florida.  US Anesthesia Partner is the largest single specialty provider of Anesthesia Services in the United States.  We are growing fast and this an incredible opportunity to join our team.  This position reports to our Payor Relations Manager.

 

 

Responsibilities

 Position Description:

  • 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 appro
  • priate 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

Job Requirements:

Three years of experience working in healthcare business office, billing, or insurance reimbursement. Must be able to manage multiple tasks in a highly-matrixed organization, have exceptionally strong customer service focus, and superb organization and communicational skills.  College degree is strongly preferred, applicable experience will be considered. Must demonstrate a positive attitude while working within a collaborative team environment.  USAP is an Equal Opportunity Employer.

PHYSICAL REQUIREMENTS:

  • Requires prolonged sitting, some bending, stooping and stretching
  • Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment
  • Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations. 
  • Requires lifting papers and boxes weighing up to 35 pounds occasionally
  • Requires dexterity to type at least 35 wpm.

 

WORKING CONDITIONS (environment and safety):

  • Work performed in office environment
  • Involves frequent contact with professional staff and managed care organizations
  • Work may be stressful at times
  • Interaction with others is frequent and often disruptive

 

disclaimer:  The above job description has been written to indicate the general nature and level of work performed by employees within this classification.  It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job.

 

 

Travel:

10% local

Location:

USAP Florida office located in Maitland, Florida

 

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