Payment Variance Analyst

4 weeks ago

New York, United States NYC Health + Hospitals Full time

About NYC Health + Hospitals:


Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible


NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.


At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.


Job Description:

• Uses statistical methods to generate and analyze recurring and ad-hoc revenue cycle reports

• Leverages data to create models that depict trends and project cash/operational performance

• Performs analysis to draw conclusions, translates data into visually simplistic deliverables, and presents findings to management

• Manage the Payment Variance EPIC WQs and create robust process to monitor and follow up on Payment Variance trends (i.e. Issues Tracking Log/Dashboard).

• Coordinate with Managed Care and facility colleagues to identify root causes of variances and track to completion.

• Tracks all debit and credit variances emphasizing reimbursement recovery and Accounts Receivable accuracy. Assists in the New Contract Implementation Quality Audit process.

• Performs ongoing analysis of contract compliance and financial performance to ensure leadership has supporting documentation during contract renegotiations

• Work with payers to resolve payment issues causing payment variance.

• Research all variances types (debit or credit) and find variance discrepancies along with modifications to correct issues

• Manages multiple projects, prioritizes work appropriately, escalates risks, and completes tasks timely with accuracy

• Submits, manages, and monitors technical support tickets to EPIC until resolved

• Develop EPIC Tip Sheets documenting billing & reimbursement guidance around new Revenue streams and/or lines of business

• Possesses the ability to adapt and respond quickly to a varying-analytical requests from several different departments

• Other related duties as needed


Minimum Qualifications:

1. A Master's degree in public administration or business administration, or in an equivalent or equally acceptable program, and four (4) years of satisfactory, full-time paid experience in a major governmental agency or large corporation or foundation in management analysis or in operational direction, planning, coordination or control of which two (2) years must have been in a supervisory, administrative or consultative capacity; or

2. A Baccalaureate degree from an accredited college or university and five (5) years of experience as stated in #1 above of which three (3) years must have been in a supervisory, administrative or consultative capacity; or

3. A satisfactory equivalent, however, all candidates must possess not less than the two (2) years of supervisory, administrative or consultative experience required. Four (4) years of appropriate general experience may be substituted for a Baccalaureate degree requirement. Appropriate full-time teaching experience in an accredited college or university may be substituted on a year-for-year basis for the required general experience and appropriate full-time teaching experience in a position of professional rank may be substituted on a year-for-year basis for the required supervisory, administrative or consultative experience.

Department Preferences

Knowledge, Skills, Abilities and other Requirements:

  • Minimum of 5 years finance experience in healthcare receivables management in a medical center or multi-hospital system or related organization
  • 2+ years of experience within hospital billing/claims processing, revenue cycle operations, revenue metrics and analytics, and revenue management or consulting experience
  • Functional knowledge of reimbursement methods of major payers.
  • Functional knowledge of Medicare and Medicaid regulatory requirements.
  • Working knowledge of CPT-4, HCPCS, Revenue Codes, and ICD-10 CM
  • Demonstrated excellence in organizational and project management skills
  • Strong verbal and written communication skills
  • Understanding of organizational policies and procedures
  • Ability to think critically and find optimal solutions for systemic problems/issues
  • Ability to adapt and manage several projects/initiatives simultaneously
  • Receptive to constructive feedback and guidance that will help reach optimal solutions
  • Proficiency in Microsoft Office, including Outlook, Word, PowerPoint, and Excel; proficient in Epic and ability to manipulate large amounts of data


NYC Health and Hospitals offers a competitive benefits package that includes:

  • Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
  • Retirement Savings and Pension Plans
  • Loan Forgiveness Programs for eligible employees
  • Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
  • College tuition discounts and professional development opportunities
  • Multiple employee discounts programs

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