Payer Contract & Reimbursement Analyst Job in West Columbia, South Carolina US
Payer Contract Reimbursement Analyst
- High School Diploma required, college degree preferred
Basic Functions: Administers all functions related to the Managed Care Departments contract management system (Contract Pro) and provide reports and analytical support related to managed care reimbursement. Position researches identified "short pays/underpayments" by contracted payers and aggressively pursue recovery of funds. Identify patterns or recurring trends with payers that consistently do not reimburse in accordance with contracts and communicate this information to the appropriate parties (supervisor, payer representatives, etc.)
Minimum Qualifications: Bachelors degree, business related, plus three years experience in healthcare/finance/managed care environment OR High School Diploma, plus 8 years of healthcare experience in finance or manage care environment Experience with mainframe, PC, and network computer systems. Knowledge of computer hardware for installation and upgrades, relational database systems, and file and system maintenance procedures. Must have knowledge in Managed Care operations as it relates to claims processing and reimbursement. Preferred Qualifications: Working knowledge of Patient Financial Services. Working knowledge of managed care terminology Procedural knowledge of hospital and physician practice accounts receivable management Working knowledge of billing/coding terminology (ICD-9, CPT, Revenue Codes)
HR Use Only:
Monster