Job Summary
Reporting directly to the Payer Contracts Manager, the Payer Contracts Analyst is responsible for payer contracting analytics. Reviews and monitors contract/payer performance. Responsible for maintaining accurate payer rate information in hospital’s systems. Responsible for overseeing ad hoc analysis in support of various HMNH initiatives.
Licensure and Certification:
Education:
Experience:
Minimum of three (3) years of experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and managed care provider reimbursement methodologies.
Knowledge and Skills:
Excel
o Advanced knowledge of complex functions.
o Advanced ability reading, creating and interpreting computer and mathematical rules and formulas.
o Advanced ability to create complex, dynamic models in which multiple scenarios can be created and compared by manipulation of key variables.
Hospital EMR and Billing Systems
o Minimum of three (3) years of experience with hospital EHR, Billing and other financial systems.
o Prefer 5 years of experience with hospital EHR, Billing and other financial systems with experience building and maintaining system rules.
o Proficiency with word processing and presentation programs such as MS Word and PowerPoint, with a preference for knowledge and proficiency with MS Access.
Working knowledge of healthcare financial statements and accounting principles.
Physical Demands – Clerical/Administrative Non-Patient Care:
Key for Physical Demands
Continuous
66 to 100% of the time
Frequent
33 to 65% of the time
Occasional
0 to 32% of the time
Payer & Managed Care Analyst • Patient Financial Services
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