Analyst- Payor Contracting and Credentialing

ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we're shaping the future of heart care in Oklahoma by serving the state and leading the nation.

• Comprehensive Benefits:
  • Medical, Dental, and Vision coverage
  • 401(k) plan with employer match
  • Long-term and short-term disability
  • Employee Assistance Programs (EAP)
  • Paid Time Off (PTO)
  • Extended Medical Benefits (EMB)
  • Opportunities for continuing education and professional growth

Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day

We can't wait for you to join our heart-centered team

The OHH Payor Contracting and Credentialing Analyst will serve as the primary contact both internally and externally for all Managed Care, Commercial, Medicaid, Tricare and Medicare contracting and credentialing functions for both hospitals and employed physicians/mid-level practitioners.  This position coordinates interaction with payors, group employers, and network representatives to accurately administer managed Care/Governmental Payor contract terms.  This position helps assist in resolution of problems associated with contractual and credentialing matters, troubleshooting and provides support to the Contracting and Compliance Officer, Revenue Cycle Group, Medical Staff and OHHP Credentialing Team and other areas as needed.  Supervises no employees.  Makes independent decisions as to the management and prioritization of daily duties.  Requires contact with the public and employees.  Handles confidential information.  Performs all work in accordance to the mission, vision and values of Oklahoma Heart Hospital.  Performs other duties as assigned.

• Proactively identify revenue generating opportunities or risks, researches and reports on payor market trends at the local and national level.
• Routinely develop, review and analyze statistical, cost, and financial reports for complex payor contracts.
• Data mine provider and payor financial and operational data for analysis. Define the necessary data elements required for the project.
• Perform testing on complex payor claims to ensure accuracy and compliance to contract terms
• Verification of payor rate schedule updates for compliance to contract terms. Educate and communicate payor methodology and/or rate changes to the appropriate internal UPMC entities and/or department staff
• Completion of all hospital, physician and mid-level provider credentialing with government, commercial, and managed care payors.

Education: Bachelor's degree preferred.  Minimum of three (3) years progressive experience in healthcare setting may be substituted for degree. 

Experience: Three (3) years of experience in a medical billing office, with two (2) years of managed care and/or credentialing experience.

Working Knowledge: Professional verbal and written communication skills.  Medical terminology and medical insurance knowledge required.  Knowledge of managed care/insurance contracts.  Knowledge of business office procedures.  Proven organization skills needed.  Knowledge of health care industry.  Excellent Customer Service background.

Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.

Learn more about diversity at Oklahoma Heart Hospital.

As part of our team, you are empowered to work collaboratively with our physicians and other caregivers, and play an integral role in setting the standard for excellence in patient care. Every team member at OHH plays an integral role in our patients' experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.