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Analyst (Remote)

Revint Solutions
Remote, OR
  • Expired: over a month ago. Applications are no longer accepted.
Job Description

Job Title: Reimbursement Payer Analyst

Company Overview

Cloudmed is a first-of-its-kind, single-source enterprise platform provider of Revenue Intelligence™ solutions for hospitals. Cloudmed’s approach of combining human expertise with advanced technology utilizing machine learning algorithms provides a smarter, more predictive way for clients to realize all potential revenue. Today, Cloudmed partners with over 3,100 healthcare providers in the United States and recovers over $1.2 billion of underpaid or unidentified revenue for clients annually. Cloudmed (Triage solution) is the 2020 Revenue Integrity and Underpayment Services KLAS® Category Leader and its solution suites have HFMA Peer Review status and are HITRUST certified.

The Optimization Suite provides best in class service, technology, and client value in the areas of DRG Validation, Charge Capture, and Transfer DRG. Our service lines use rules engines and auditor review processes to validate coding and revenue integrity, such that we enable our provider clients to accurately capture owed revenue.

DESCRIPTION

As a Reimbursement Payer Analyst for the Optimization Suite, you will provide payer mapping support to drive revenue, enhance process flows, and reduce avoidable write-offs. In this role, you will also review payer contracts as needed to address payer reimbursement and scope questions. You will report to the Senior Reimbursement Payer Analyst, with whom you will work closely to ensure Optimization suite payer mappings and Reimbursement team claim statusing are as accurate as possible.

RESPONSIBILITIES

  • Reduce revenue write-offs through data analysis, trend identification, and solutioning
  • Compile initial payer mappings for new clients as a part of the go-live process
  • Address payer contract and scope questions posed by the Reimbursement Team by reviewing payer contracts and internal data
  • Contribute towards achievement of Optimization Suite service line goals
  • Assist with regular review and analysis of invoiced and removed volume to evaluate claim statusing accuracy
  • Execute deep-dive investigations of “no lift/lesser payment volume” across active tenants in order to identify trends, adjust payer scope, and minimize future removals; this research may include but is not limited to: contract review, HIS research, CDP research, and payer phone calls.
  • Support DRG-V/CC RSG payer follow-up efforts, as needed
  • Perform additional tasks to support the operation of the Reimbursement Team, as needed

WHO WE’RE LOOKING FOR

  • 1+ years of experience in data and/or payer contract analysis
  • Self-starter who is eager to learn, and can work both independently and in a team environment
  • Strong analytical, organizational, and professional skills
  • Excellent time management and creative problem-solving skills
  • Team-oriented with strong interpersonal and communication skills
  • Intermediate Excel and SQL skills preferred
  • Proven knowledge of Commercial and Government reimbursement preferred

CULTURE FIT

The culture at Cloudmed embraces those that demonstrate a deep passion for solving the problems of healthcare with enthusiasm for building positive working relationships and winning as a team. Take the work seriously, but don’t take yourself too seriously. Creating a strong workplace culture has been one of our staples, which we believe encourages and inspires employees to do their best. Join a fulfilling team of like-minded individuals who can get their work done, but still have fun!

BENEFITS

Cloudmed provides an extremely competitive benefit package that includes a 401(k) match, medical/dental/vision insurance and more.

BEING YOU @ CLOUDMED

Cloudmed recruits, employs, trains, compensates, and promotes regardless of race, religion, color, national origin, sex, disability, age, veteran status, and other protected statuses. At Cloudmed, we have a clear vision: to be a place where a diverse mix of talented people feel supported and empowered to reach their full potential. We pride ourselves on delivering premium results and client service to all our hospital clients. Cloudmed runs on the hard work and dedication of our passionate and diverse employees.

Cloudmed is an Equal Opportunity Employer

Revint Solutions

Address

Remote, OR
USA

Industry

Healthcare

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