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Payer Performance Manager

2 months ago

SPRINGFIELD, United States Navient Full time

Xtend Healthcare is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.

Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.

THIS POSITION CAN BE REMOTE IN CHICAGO, IL or ON-SITE AT MT. SINAI HOSPITAL.

The Payer Performance Manager will have healthcare data analytics, informatics and a healthcare revenue cycle background. This role will assist Xtend clients in ensuring that payers are paying according to their contract guidelines. This role will also include payer denial analysis, trending and report building. The Payer Performance Manager will work with all areas of Revenue Cycle to ensure reimbursement for the hospital.  The analyst will be required to produce weekly reporting on weekly financials and payer issues as well as manage all the payer meetings, including creating the payer agenda, reporting claim issues and working directly with payer representatives for claim resolution. The Analyst will work with Xtend proprietary tools to analyze large volumes of hospital data. The role will require various technical data manipulation techniques to analyze large complex data sets, identify data patterns, data mine, etc. Candidates must communicate data trends to Revenue Cycle Leadership as well as Payer Representatives.

JOB SUMMARY:

1.   Analyze large volumes of hospital data and weekly/monthly reporting   

           

2.   Employ various techniques to analyze large complex data sets:   

  • Data manipulation
  • Data mining
  • Identifying data patterns

3.   Weekly Revenue Cycle and Payer Reporting                         

  • Communications

4.   Payer Meetings- (Contracted Insurance Carriers)

  • Preparing meeting agenda
  • Running Payer meetings
  • Following up for any action items related to payer meetings

MINIMUM REQUIREMENTS:

  • High school diploma with some college - Business, Informatics, Data Analytics, Finance, Accounting , or a related field (additional equivalent experience above the required minimum may substitute for the required level of education)
  • 3+ years working with data in a hospital billing/claims environment (additional equivalent education above the required minimum may substitute for the required level of experience)
  • 2+ years working with Government and Commercial payers or equivalent years of experience with payer contracting
  • Advanced level proficiency with Microsoft Excel required
  • SQL or other database software experience

PREFERRED QUALIFICATIONS:

  • Meditech or other EMR experience preferred
  • Illinois Medicaid payer knowledge
  • Bachelor’s Degree Preferred
  • Acute attention to detail and strong analytical skills (required)
  • Strong understanding of Revenue Cycle, Commercial and Government Payers
  • Strong written and verbal communication skills
  • Ability to employ critical thinking skills and work independently while also working well within a team environment
  • Receptiveness to differing views and ideas with the ability to apply industry-specific concepts
  • Highly adaptable to changing circumstances and/or directives in day-to-day priorities
  • Ability to perform well on frequent repetitive tasks while continually improving skills and competencies
  • Comfortable in faced paced working environment
  • Ability to manage and complete short- and long-term projects
  • Ability to set and meet deadlines
  • Willingness to travel occasionally

All offers of employment are contingent on standard background checks. Navient and certain of its affiliated companies are federal, state and/or local government contractors. Should this position support a Federal Government contract, now or in the future, the successful candidate will be subject to a background check conducted by the U.S. Government to determine eligibility and suitability for federal contract employment for public trust or sensitive positions. Positions that support state and/or local contracts also may require additional background checks to determine eligibility and suitability.

EOE Race/Ethnicity/Sex/Disability/Protected Vet/Sexual Orientation/Gender Identity. Navient Corporation and its subsidiaries are not sponsored by or agencies of the United States of America.

Navient is a drug free workplace.