Payer Reimbursement Analyst at USPI

Courtry, Ile-de-France, France -

Full Time

Start Date

Immediate

Expiry Date

03 Jul, 26

Salary

0.0

Posted On

04 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Payer reimbursement, Contract administration, Managed care contracts, Revenue cycle management, Medicare coverage, Data analysis, Claims processing, Financial reporting, Insurance trends, Communication skills, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Microsoft Outlook, Vision software, AdvantX software

Industry

Hospitals and Health Care

Description

Position Overview: Reporting to the Director of Reimbursement, the Payer Reimbursement Analyst is responsible for reviewing payer contracts and payment policies, fully understanding, summarizing, and distributing the contract summaries to the team in a format that is easily comprehended. They will also provide direction in the development of critical RCM initiatives and goals, leading and managing key projects including, ensuring maximum reimbursement is obtained accurately and timely. Responsibilities: * Ensures Managed Care Contracts are loaded timely and accurately into the appropriate systems. * Provides timely and accurate contract summaries, highlighting payer reimbursement methodologies, rates, and key areas necessary for accurate claims processing. * Create, disseminate, and participate in the presentation of educational materials in relation specific to contracts and reimbursement strategy. * Leads the effort with payer specific training of new hires and continuing payer specific education of existing team members * Stay current on industry and insurance trends in the reimbursement and managed care areas and the application of industry best practices that are aligned with reimbursement and commercial strategies. * Proactively participates in activities that improve department operations and/or support to the department for quality improvements * Identify system contractual issues and implements appropriate tasks to bring AR closer to true expected reimbursement * Maintains library of information/tools related to documentation guidelines and communicates this information to applicable teams * Assist in determining reimbursement approach, strategy, and reimbursement trend awareness. * Supports Revenue Cycle Operations in evaluating future reimbursement initiatives along with tracking, reporting and providing feedback. * Procures and maintains Medicare coverage across all LCDs * Monitor important Medicare and private payer reimbursement policies that may have a significant impact on ASC reimbursement. * Other tasks, projects, and training as needed.

Responsibilities

The Payer Reimbursement Analyst is responsible for reviewing and summarizing payer contracts to ensure accurate claims processing and maximum reimbursement. They also lead revenue cycle initiatives, manage contract loading, and provide educational training on reimbursement strategies to the team.