Payer Provider Engagment Anlayst

Responsibilities

• Serves as a liaison between the organization and its payers.
• Compiles payer data and understands health plan requirements around billing, documentation, authorization, processes, policy changes, and more.
• Edits Legacy Health staff about these requirements.
• Analyzes trends around payer denials and outstanding A/R, and works with internal departments, as well as external payers, to resolve identified issues.

Qualifications

• Bachelor’s Degree in Business, Healthcare Administration, Information Systems, Computer Science or equivalent degree OR equivalent experience.
• Master’s degree preferred.
• Five years of experience in healthcare billing, follow-up, or denials management required.
• Minimum of three years’ experience in payer contracting or payer relations management required.
• Prior hospital or health care experience with emphasis on workflow and procedures, operations management, financial management and reimbursement issues required.
• Quality Assurance, project management, and leadership experience required.

Skills

• Ability to promote/support management with payer relations, A/R management, and insurance plan requirements.
• Development and maintenance of reports by payer and plan level detail (e.g. Trends, action plans).
• Must have in-depth knowledge of payer requirements.
• Strong analytical skills and experience with various analytic and reporting solutions.
• Strong interpersonal skills, including excellent written and verbal communications.
• Ability to effectively communicate with various levels of staff, both internally and externally.
• Strong understanding of healthcare billing, follow-up, and denials management processes and systems.

Pay

USD $41.04 - USD $61.16 /Hr.