Revenue Cycle Payer Perf and Relations Analyst

About the role

We are seeking a Revenue Cycle Payer Performance and Relations Analyst to join our Revenue Cycle team. This position reports to the Revenue Cycle Analytics Manager and serves as a critical liaison between the contracting and revenue cycle departments.

Responsibilities

• Act as a bridge between contracting and revenue cycle departments, ensuring payer-specific requirements are integrated for clean claims processing.
• Oversee commercial billing and collections reporting in collaboration with revenue cycle management.
• Maintain effective relationships with external agencies and professional groups related to contractual agreements.
• Develop and analyze performance metrics that align with strategic revenue cycle goals.
• Maintain SharePoint contract databases and distribute recurring reports to leadership.
• Conduct contract redlines and analyze payer contract language, billing rules, provider manuals, and payer guidelines.
• Analyze and report on trends, root causes, and adjustment activity.
• Support Request for Proposal (RFP) development and payer research activities.
• Participate in payer implementations, in-services, and credentialing processes.
• Develop and maintain payer-specific Quick Reference Guides (QRGs), including non-par and managed care contracts.
• Interpret and configure payer rules in system databases to support accurate reimbursement and reduce held claims.
• Provide ongoing education and support to department personnel.
• Complete tasks and special projects as assigned by leadership.

Requirements

• Bachelor’s degree in healthcare administration, business, or related field.
• At least 3 years of billing and collections experience, with a strong background in hospice billing.
• Familiarity with Homecare Homebase (HCHB) billing platform preferred.
• Knowledge of federal and state regulations, HIPAA privacy laws, CPT and ICD-9/10 coding.
• Understanding of AR functions, payer guidelines, and healthcare contract language.
• Experience with SharePoint, Microsoft Excel, SQL, and Power BI preferred.
• Ability to interpret complex payer policies and communicate clearly to cross-functional teams.
• Excellent problem-solving, prioritization, and multi-tasking skills.
• Strong attention to detail and ability to work both independently and in a collaborative team environment.
• Skilled in navigating multiple digital platforms and project management tools.

Qualifications

• Skilled in interpreting complex payer policies and communicating clearly to cross-functional teams.
• Strong problem-solving, prioritization, and multi-tasking skills.
• Attention to detail and ability to work independently and collaboratively.
• Proficient in navigating multiple digital platforms and project management tools.