Contract Variance Specialist - TriHealth : Job Details

Job DescriptionJob Overview: The major responsibility of this position will be to identify payment variances at the account level based on expected reimbursement from contracted managed care payers, governmental payers and non-contracted miscellaneous payers. Knowledge and experience with revenue cycle, including the billing, follow up and payment processes, will be critical for success in this role, as well as experience with payer contract language and various payment methodologies. Knowledge of the Patient Access and/or HIM functions would also be helpful. Critical thinking skills, as well as the ability to identify trends and/or process improvement opportunities will be expected. This position will be the contract language expert for our many payers. To perform this role, working knowledge of various billing and payers systems will be required, as well as the ability to compare, analyze and communicate trends and/or problems is essential. This is a working position, meaning accounts identified to have a contract variance will be worked until payment as expected is received. Job Requirements: Associate's Degree or Diploma in Business, Healthcare, or other related field Equivalent experience accepted in lieu of degree Working knowledge of Epic Resolute, Excel, understanding of managed care contracts and payment terms 3-4 years experience Professional Healthcare Revenue Cycle Billing and Follow Up experience Patient Access and/or HIM knowledge Experience Management Healthcare Job Responsibilities: Other job-related information: Work Environment: Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports Requires lifting papers or boxes up to 25 pounds occasionally Work is performed in an office environment. Contact may involve dealing with angry or upset people Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations Able to effectively manage exposure to potentially infectious material per OSHA guidelines Working Conditions: Climbing - Rarely Concentrating - Consistently Continous Learning - Frequently Hearing: Conversation - Consistently Interpersonal Communication - Consistently Kneeling - Occasionally Lifting