Payment Variance Analyst

5 months ago

Kansas City, United States University Health Full time

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Payment Variance Analyst101 Truman Medical Center

Job Location

Truman Support CenterKansas City, Missouri

Department

Patient Accounts

Position Type

Full time

Work Schedule

7:30AM - 4:00PM

Hours Per Week

40

If you want to work where the action is, University Health (UH) is the place for you. Known as “Kansas City’s Essential Hospital,” UH is the safety net healthcare system for Jackson County/Kansas City. We are an academic medical center, serving as the primary teaching institution for the UMKC Schools of Medicine, Nursing, Dentistry, and Pharmacy. A 547-bed, not-for-profit health system, UH delivers the highest-quality medical care for our patients, with compassion, empathy, and unparalleled dedication to service. During the 2020 pandemic, we also stepped forward as a regional leader in COVID care and testing. UH is comprised of three campuses:

UH Truman Medical Center is located in the Health Sciences District of downtown Kansas City, Missouri. The Health Sciences District represents a robust academic community, leading the forefront of biomedical research and cutting edge technology. Partnered with UMKC and Children’s Mercy Hospital. University Health serves as the cornerstone in educating the next generation of healthcare practitioners. As a Level 1 Trauma Center, we’re a leader in Emergency Medicine and Critical Care, with world-class expertise in chronic disease management and women’s services, including high-risk maternity care. The Health Sciences District is also home to the University Health 1 and 2 buildings. UH 1 is UH’s beautiful specialty outpatient clinics and day-surgery center and UH 2 is the location for all of our primary care and women’s care clinics.

UH Lakewood Medical Center is located between Kansas City and Lee’s Summit, Missouri, offering residents of Eastern Jackson County access to a modern community hospital with a continuum of outpatient services designed to meet the needs of families. UH Lakewood specializes in high-risk maternal and child care, and serves as one of the few Kansas City metro area institutions accredited by The Joint Commission in Orthopedics and Palliative Care. It also is home to a 188-bed, fully accredited long-term care center.

UH Behavioral Health is the KC metro area’s largest, most comprehensive provider of mental health services. The Crossroads Building , located in Kansas City’s vibrant Crossroads Arts District, is its epicenter, providing a broad list of outpatient services. We also offer psychiatric inpatient care, and we deliver therapeutic services through our community outreach clinics. We are a leader in the Trauma-Informed Care Movement, and provide training, coaching and consulting to outside organizations.

Job Description

The Analyst will evaluate and understand contract language as it relates to reimbursement methodologies including those involving, but not limited to, Per Diems, DRG’s, Fee Schedules and Percent of Charge Mechanisms. Evaluates payer performance through analysis, investigation and facilitation of resolution. Communicates contract issues, interpretation and modifications to internal/external parties, as appropriate. Duties include reviewing, analyzing and appealing payer underpayments, payer contract variance recoveries and conducting follow up activity with Managed Care team for rate sheet modifications. The Analyst will provide customer service/provider service resolution by identifying and communicating problems with key contracts.

Has extensive knowledge in Medicare, Medicaid, and third party payment programs. Thorough understanding of payer contract terminology. This position is considered a subject matter expert and uses level of proficiency and knowledge to ensure quality and efficiencies in operational processes.

Meets quality measures set forth by regulatory compliance standards, organization, and department. Displays high customer service standards. Serves as a key point person for providing organization details for underpayment and denials. Has a strong ability to communicate information to peers, and management. 

Minimum 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 such as ICD/CPT/HCPC coding, revenue codes, ICD10 and knowledge of 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

Health care experience in a hospital setting.

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