Revenue Cycle Analyst, Payor Knowledge

Job not on LinkedIn

🔥 13 hours ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $64.1k - $80.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Village Medical

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2014

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Village Medical is revolutionizing primary healthcare by focusing on making care more accessible and personalized, especially for adults over 65. With services that include in-clinic, in-home, and virtual visits, Village Medical ensures comprehensive and coordinated care through a team approach. They prioritize wellness by offering personalized care plans and welcome most insurance, including Medicare Advantage plans. Their widespread presence in over 680 locations, many within Walgreens, enables them to be easily accessible to their patients. Village Medical's commitment to their patients is reinforced by the ability to manage appointments and prescriptions through their free app, enhancing convenience and connectivity in healthcare management.

📋 Description

• Manage the contract management tool, Rivet • Oversee SHM Revenue Cycle fee-related tablespaces • Support prioritization and implementation of system changes and updates • Troubleshoot issues and inquiries from end users • Coordinate and participate in project task deliverables • Prepare for and attend payer meetings • Review, interpret, extract, and organize key information from payer contracts and amendments into the Payer Contract Matrix • Create, maintain, and validate fee schedules based on contract payment sources and reimbursement rates • Analyze reimbursement data to identify discrepancies, payer trends, and opportunities for maximizing reimbursement • Research payer contract documentation and payer websites to ensure contract compliance and reimbursement integrity • Communicate identified opportunities and trends internally and externally with data support • Compile reports for RCM team members to review unfavorable claim outcomes, pursue recovery of underpayments, or submit corrected claims • Initiate contact with payers to validate contracted rate discrepancies • Collaborate with the Payor Knowledge team to resolve fee schedule errors, load new codes, and map payers • Work with product and technology teams to develop new technology solutions or enhance existing software • Prepare client-facing reports and special projects related to contracts and fee schedules, including Charge Master Analysis, Quarterly Payer Scorecard Reports, Claim Analysis Reports, and Underbilling Alerts

🎯 Requirements

• Strong analytical skills to reconstruct multi-step processes and correct sources of error • Extensive knowledge of Revenue Cycle applications, including updates and enhancements • Basic understanding of medical billing, including charge entry, EOB/remittance review, payment posting, and reconciliation practices • Excellent verbal and interpersonal communication skills, with the ability to explain problems, solutions, and changes effectively • Proficiency with computer systems and the ability to quickly adapt to new programs and websites • Ability to interpret contract language and manage contract database updates • Advanced analytical and research skills with strong attention to detail and the ability to manage multiple complex contracts simultaneously • Knowledge and experience with various practice billing software systems, including understanding the workflow, processes, and billing procedures • Familiarity with clinic, provider groups, and hospital revenue cycle and insurance payment methodologies • Expertise in payer contracts, insurance types, and related billing and reimbursement policies • Ability to manage payer contract, fee schedule, and analysis responsibilities across multiple business units • Knowledge of state, federal, and commercial payer reimbursement rules, policies, and methodologies • Industry certifications (e.g., CSPR, CRCR, CHAM, CHFP, FHFMA, FACHE) are a plus

🏖️ Benefits

• Medical coverage • Dental coverage • Life coverage • Disability coverage • Vision coverage • FSA coverage • 401k savings plan