Patient Account Analyst – Payor Relations

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🔥 1 minute ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 13%

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Duke Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

💼 Consulting

🏥 Healthcare

📚 Education

Consulting • Healthcare • Education

Duke Careers is a platform connected to Duke University's rich legacy, established in 1924. It aims to celebrate the centennial of Duke University while providing resources, stories, and interviews that reflect the university's history, current achievements, and future aspirations. A key focus of Duke Careers is to engage with alumni and the community, showcasing the transformative impact of education and leadership within the university.

📋 Description

• Develop and maintain strong working relationships with governmental and non-governmental payers • Engage payers to resolve unpaid accounts • Collaborate with contracting management to implement regulatory updates and support billing and collections • Assist with managing the onsite Blue Cross BlueShield relationship • Maintain and update the managed care contract matrix • Monitor operational and legislative issues affecting the organization • Conduct in-service and bulletin meetings and distribute payer newsletters • Educate clinical and PRMO operational leadership • Review payer websites and track operational issues • Compile and distribute the monthly payer newsletter • Represent DUHS and DHIP in relevant payer engagements • Analyze denial reports, trends, and performance • Research denial root causes using account, reimbursement, and policy information • Identify and implement process improvements to reduce denials • Advise operational staff on rejection and denial codes and resolution actions • Communicate with third-party payers about operational and workflow issues • Develop and maintain workflow and policy documentation • Maintain knowledge of team functions, payer requirements, systems, and operational procedures

🎯 Requirements

• Bachelor’s degree in business, healthcare administration, accounting, finance or a related field is required • Minimum of four years of applicable experience • Previous experience successfully managing complex projects involving multiple stakeholders with a consistent track record of delivering on time, or high-quality results preferred • A master’s degree in a related field can substitute two years of experience on a 1:1 basis • Working knowledge of relevant payor billing requirements and reimbursement regulations • Working knowledge of core systems including Maestro Care and ancillary systems such as Availity, Hyland, and payor-specific portals • Proficient knowledge of Outlook, Excel reporting, Word processing, Visio flowchart, PowerPoint presentation, ServiceNow Change Controls, I-forms, and API/PTO

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