Job Summary
Reporting directly to the Payer Contracts Manager, the Payer Contracts Analyst is responsible for payer contracting analytics. Reviews and monitors contract/payer performance. Responsible for maintaining accurate payer rate information in hospitals systems. Responsible for overseeing ad hoc analysis in support of various HMNH initiatives.
Licensure and Certification:
N/A
Education:
Minimum Bachelors Degree in economics, accounting, finance, healthcare policy, business administration.
Preferred Masters Degree in economics, accounting, finance, healthcare policy, business administration.
Experience:
Minimum of three (3) years of experience in financial healthcare reimbursement analysis is required, including an understanding of national standards for fee-for-service and managed care provider reimbursement methodologies.
Knowledge and Skills:
- Excel
- Advanced knowledge of complex functions.
- Advanced ability reading, creating and interpreting computer and mathematical rules and formulas.
- Advanced ability to create complex, dynamic models in which multiple scenarios can be created and compared by manipulation of key variables.
- Hospital EMR and Billing Systems
- Minimum of three (3) years of experience with hospital EHR, Billing and other financial systems.
- Prefer 5 years of experience with hospital EHR, Billing and other financial systems with experience building and maintaining system rules.
- Proficiency with word processing and presentation programs such as MS Word and PowerPoint, with a preference for knowledge and proficiency with MS Access.
- Working knowledge of healthcare financial statements and accounting principles.
Physical Demands - Clerical/Administrative Non-Patient Care:
- Frequent sitting and standing/walking with frequent position change.
- Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
- Occasional/intermittent reaching at or above shoulder level.
- Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.
- Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
- Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.
Key for Physical Demands
- Continuous: 66 to 100% of the time
- Frequent: 33 to 65% of the time
- Occasional: 0 to 32% of the time