US Anesthesia Partners

  • Title
    Payer Compliance Analyst
    Job ID
    2019-4403
    Location
    US-FL-Maitland
    Function
    Revenue Cycle Management
    Employment Status
    Full-Time
  • 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. 

     

    The Payer Compliance Analyst plays a key role within the CBO.  This position is responsible for analyzing allowed amounts received on USAP claims to determine appropriateness per contract.  Utilizing tools and reports, this individual will review variances in payments, and request corrections as necessary for USAP to receive full allowance per contract.  Additionally, this individual is responsible for working to identify and resolve payer issues that negatively impact receivables.

    The Payer Compliance Analyst has frequent and direct contact with various CBO departments and insurance companies, therefore it is essential that the candidate demonstrates a positive demeanor, good verbal and written communication skills and is professional in both appearance and approach.  The position requires independent thinking skills, good interpersonal skills, problem-solving abilities and an understanding of the operational needs of the CBO revenue cycle and its strategy.  Additionally, this position requires good analytical skills to identify trends and issues, as well as to identify possible solutions to address any issues. It is important that the Payer Compliance Analyst can meet deadlines and other requirements set by the Management Team.  The candidate must be able to handle potentially stressful situations and multiple tasks at one time.

    Responsibilities

    • Daily review of variance data to identify and validate payer underpayments.
    • Coordinate with A/R department, to update Analyzer parameters, such as establishing additional calculations or changing existing calculations in accordance with payer policy.
    • Understand payer reimbursement policies to validate variances through calculations. 
    • Inform the Management Team of any problems or changes in payer performance.  Exercise independent judgment to analyze and report repetitive payer failures so corrective actions can be taken.
    • Utilizing the Payer Compliance Module to analyze and evaluate payer variances, identity variance trends with payers, track submitted appeals and escalate issues to Management.
    • Well-developed problem-solving skills, including the ability to identify appropriate payer solutions, and follow through with contacting the payer for project assignment.  Responsible for review of completed project assignment upon receipt.
    • Document actions in format appropriate to task
    • Maintain a positive working relationship with contacts at all agencies, insurance companies, government entities, providers, other CBO staff and management, to promote teamwork, cooperation, and a positive image.
    • Possess exceptional communication and interpersonal skills in order to effectively interact with customers, department management and CBO staff.
    • Stay abreast of the latest developments, advancements, and trends in the field of revenue cycle management by reading professional journals and insurance newsletters.   Integrate knowledge gained into current work practices.
    • Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing.
    • Attend scheduled department meetings and training sessions. 
    • Identify repetitive payer- and/or internal billing occurrences for resolution of on-going items
    • Maintains strictest confidentiality.
    • Other duties, as assigned

    Qualifications

    • Skill in computer applications including MS Word and MS Excel. 
    • Basic knowledge of managed care programs and billing requirements necessary. 
    • Analytical abilities required to identify and resolve underpayments relating to specific payers, coding issues, etc.            
    • Skill in keyboarding/data entry.
    • Good mathematical skills a must.
    • Skill in verbal and written communication. 
    • Detailed oriented – ability to drill into the details of a claim and summarize issues
    • Skill in gathering and reporting information. 
    • Ability to work effectively with staff, physicians and external customers.  Must display teamwork attitude and good inter-personal skills.
    • Must have a pleasant disposition and high tolerance level. 
    • Ability to work independently with limited supervision.
    • Familiarity with basic medical terminology and concepts preferred.
    • Knowledge of CPT, ICD-9, and ASA coding.
    • Communicate well with the public
    • Experience in Accounts Receivable or Payment Posting a plus
    • Ability to read, write, and speak English

     

    Required Education & Experience:

     

    • High School graduate or equivalent
    • 3+ years of experience in a healthcare business office, specifically collections and/or payment posting, is required. 
    • Functional knowledge of Excel and Word is required.

     

    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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