Revenue Cycle Integrity Analyst (Hybrid)

Our client is a large-scale healthcare provider. They have over four decades of experience providing pharmacy, clinical, and nonclinical care to patients both at home and throughout their community.

They focus on quality, innovation, and improving their community as a whole. They are looking for a Revenue Cycle Integrity Analyst to join their growing team.

In this role, you will serve as the process owner for payer plan maintenance, managing contracts across various lines of business.

This includes collaborating with operational and IT teams to ensure accurate communication and education regarding payer contracts and rate changes.

This Role Offers :

• Competitive base salary plus comprehensive benefits, including medical / dental / vision, 401(K), and more.
• Stable company with over seven decades of experience.
• Tight-knit culture focused on taking care of their employees.
• Ample opportunities for growth and career advancement.
• High employee tenure with low red tape culture. They hire professionals and trust their expertise, giving them room to make tangible impacts.

Focus :

• Serve as the process owner for payer plan maintenance, managing contracts for various lines of business.
• Maintain an up-to-date repository of payer contracts, amendments, and renewals.
• Audit contracts prior to movement into the production contract management system.
• Translate payer contracts into a shared site for tracking and reference.
• Analyze and resolve specific billing edits / errors delaying claims processing.
• Ensure accurate payer setup and contractual allowance calculation in multiple billing systems.
• Collaborate with cross-functional teams to ensure correct interpretation and timely loading of contracts.
• Conduct in-depth analysis of payer contracts, identifying opportunities for system improvements.
• Assist with fee schedule negotiations and value-based care initiatives.
• Stay current on healthcare regulations and reimbursement policies.
• Generate comprehensive reports and conduct data analysis to track contract performance and financial outcomes.
• Present findings and recommendations to management for informed decision-making.

Skill Set :

• Bachelor’s degree in Accounting, Business, or related field preferred.
• 3+ years of experience in contract management, reimbursement methodology, or payer relations.
• Prior experience in contract negotiation and management plus knowledge of healthcare compliance and regulations.
• Strong knowledge of payer contracts, healthcare reimbursement methodologies, and regulations.
• Proficiency in healthcare revenue cycle software and data analytics tools.
• Exceptional communication, negotiation, and relationship-building skills paired with the ability to work independently and collaboratively in a team.
• Analytical mindset with problem-solving capabilities and detail-oriented with strong organizational skills.
• Must reside within the following locations : Arizona, Kentucky, Texas and Tennessee.
30+ days ago