Payment Variance Analyst
1 week ago
Job Summary
The Payment Variance Analyst will play a critical role in ensuring accurate reimbursement for University Health. This position will be responsible for evaluating and understanding contract language related to reimbursement methodologies, including Per Diems, DRG's, Fee Schedules, and Percent of Charge Mechanisms. The Analyst will also communicate contract issues, interpretation, and modifications to internal and external parties as needed.
Key Responsibilities
- Evaluate and understand contract language related to reimbursement methodologies
- Communicate contract issues, interpretation, and modifications to internal and external parties
- Review, analyze, and appeal payer underpayments and payer contract variance recoveries
- Conduct follow-up activity with Managed Care team for rate sheet modifications
Requirements
- Bachelor's degree or equivalent obtained through a combination of education and experience
- Minimum of two years' experience in managed care or government payer payment variance reconciliation
- Experience with 837i and HIPAA transaction sets, including ICD/CPT/HCPC coding, revenue codes, ICD10, and medical terminology
- Critical thinking and problem-solving skills
- Proficient in use of Microsoft Office products
- Expert level in use of spreadsheets for analysis purposes
- Graphic presentation skills
- Ability to demonstrate attention to detail
- Excellent communication skills, oral, written, and by use of telephone
- Excellent customer service skills
Preferred Qualifications
- Healthcare experience in a hospital setting
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