Payer Performance Analyst Lead

Monument Health•Rapid City, SD

1d•$26 - $33

About The Position

Provides analytical and technical support to the Revenue Cycle team in the planning, implementation, coordination and ongoing system maintenance of the denial, underpayment and contract modeling system, currently Payment Integrity Compass (PIC). Maximizes the Health System's revenue recovery efforts through effective coordination of the usage of Payment Integrity Compass by various Revenue Cycle staff. Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include: Supportive work culture Medical, Vision and Dental Coverage Retirement Plans, Health Savings Account, and Flexible Spending Account Instant pay is available for qualifying positions Paid Time Off Accrual Bank Opportunities for growth and advancement Tuition assistance/reimbursement Excellent pay differentials on qualifying positions Flexible scheduling

Nice To Haves

Experience - 1+ years of Hospital Experience
3+ years of Revenue Cycle Experience
Education - Bachelors degree in Healthcare Administration or Related Field

Responsibilities

Thoroughly understands the wide variety of reimbursement methodologies used through the Healthcare receivables industry.
Functions as a super user for implementation and maintenance of computerized denial, underpayment contact modeling system.
Responsibilities include verification and accuracy of data, compiling data and ability to translate information into multiple formats (Excel, Access, PowerPoint and white paper format).
Provides monthly reporting that assists in identifying root causes of denials, underpayments, payer response and resolution to existing and prospective AR.
Responsible for coordinating work efforts needed to identify trends in underpayments, denials, revenue opportunities and revenue leakage.
Works closely with each department responsible for root causes to trend issues and provides feedback that will result in reduced preventable denials and underpayments.
Works collaboratively with respective departments to evaluate trends and be part of the team that works towards resolution.
Works in collaboration with Managed Care Manager to obtain current Payer fee schedules and ensure accurate and timely loading, auditing, and validating of contract information.
Creates and reviews operational reports for identification of improvement opportunities and makes recommendations to re-engineer processes.
Participates in Managed Care, Value Based Incentive Program Committee meetings and provides reports and analytics for presentations as needed.
All other duties as assigned.