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Revenue Cycle Payer Relations Analyst

4 months ago

Coral Gables, United States InsideHigherEd Full time
Current Employees:

If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet.

The Central Business Office has an exciting opportunity for a Full-Time Revenue Cycle Payer Relations Analyst to work Remote. The Revenue Cycle Payer Relations Analyst performs analysis, tracks and develops performance improvements to support and enhance processes within the Revenue Cycle Department. This role develops and maintains excellent relations with payers, serves as an expert resource for payer policies, provides accurate and complex data analysis of reimbursement for all payers, and develops recommendations for optimal managed care reimbursement. The Revenue Cycle Payer Relations Analyst will also collaborate with internal staff to resolve issues related to the revenue stream.

  • Analyzes and monitors payer trends, managed care contract compliance, contract and payer yield and indicators that reflect new opportunities for revenue or charge capture, operational improvements and increased reimbursement.

  • Performs accurate and timely accounts receivable management. Analyzes accounts receivable transactions to ensure compliance with internal controls and accounting policies. Maintains and reconciles accounts receivable ledger and prepares management reports, including reports of delinquent accounts. Analyzes trends in bad debts and recommends improvements to accounts receivable policies and procedures.

  • Works closely with all Revenue Cycle Departments and Managed Care. Partners with internal staff to resolve issues related to the revenue stream. Coordinates with departments and insurance companies to correct errors as necessary. Documents and tracks all revenue cycle payer issues. Leads payer contract loads for underpayment recovery.

  • Conducts analysis and outcome assessments on issue report. Communicates changes and prepares weekly reports that assist Revenue Cycle leadership.

  • Maintains all documentation for the Payer Relations Team within Revenue Cycle to include Revenue Cycle Payer Relations emails via Resource Box in MS Outlook.

  • Coordinates payer visits to learn about any portal enhancements, guidelines updates, contract updates. Assists with payer in-service training upon request.

  • Audits proper use of account resolution from identification stage through resolution.

  • Monitors reimbursement regulations. Maintains knowledge of current legislation concerning HMO appeals on both national and state levels.

  • Ensures appropriate coverage for compliance standards and revenue generation. Participates in management and other meetings as necessary. Attends all payer JOC (joint operating committee) meetings and represents the organization at the state level by attending statewide payer teleconference meetings with FHA, CMS, and HFMA.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.

MINIMUM QUALIFICATIONS

  • Associate degree in relevant field.

  • Minimum 5 years of relevant experience

  • HFMA CRCR Certification Required

  • Ability to exercise sound judgment in making critical decisions.

  • Skill in completing assignments accurately and with attention to detail.

  • Ability to analyze, organize and prioritize work under pressure while meeting deadlines.

  • Ability to work independently and/or in a collaborative environment.

  • Ability to communicate effectively in both oral and written form.

  • Ability to maintain effective interpersonal relationships.

  • Proficiency in computer software (i.e., Microsoft Office)

Any appropriate combination of relevant education, experience and/or certifications may be considered.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:Full timeEmployee Type:StaffPay Grade:H9