Job Description

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Full Time

Job Summary: The Contract Variance Specialist will research payment policies and review potential underpayments/overpayments on both facility and professional accounts. This role will work with payers directly to ensure reimbursements are aligned with negotiated contracts.

Minimum Education: High School diploma or GED.


Licensure, Registration and/or Certification: None.

Work Experience: Minimum 3 years of experience in combined/comprehensive contract variance review/analysis, healthcare claims in billing and/or collections, or any combination of experience listed.

Knowledge, Skills and Abilities: Demonstrated knowledge of Epic HB and/or PB workflow process, preferred. Working knowledge of payer reimbursement methodologies. Excellent communication skills, both written and verbal that present clear and concise information to a diverse audience. Advanced level skills utilizing reporting data packages, including Excel.


Essential Functions and Responsibilities: Identifies system contract updates that will be built to accurately reflect expected reimbursement based on payment methodologies. Prepares and analyzes monthly variance reports to present to Revenue Cycle Leadership that identifies trends by payer of payment variances. Develops contracts and payer expertise that leads to the identification of payment errors and reconsideration/reprocessing workflows. Presents recommendations based on variance trending to varied audiences. Researches, identifies, and follows up on contract underpayments/authorization denials resulting from contract misinterpretation.


Decision Making: The carrying out of non-routine procedures under constantly changing conditions, in conformance with general instructions from supervisor.


Working Relationships: Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job. This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

Patient Accounting - Yale Campus

Location:
Tulsa, Oklahoma 74136

EOE Protected Veterans/Disability Saint Francis Health System

Job Tags

Full time, Contract work, Work experience placement,

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