Analyst, Revenue Cycle Payor Knowledge
Core
Interpret and analyze payer contract terms and reimbursement methodologies to create fee schedules, identify discrepancies, and maximize reimbursements.
Role type
Analyst, Revenue Cycle Payor Knowledge
Builds
Accurate fee schedules, payer contract matrices, and reports for claim recovery and underpayment analysis.
Domain
Healthcare revenue cycle management and payer contracting
Deliverable
production ML models | product features | dashboards & analysis | client delivery
Required skills
Contract interpretation, fee schedule management, reimbursement data analysis, payer trend analysis, report compilation, system troubleshooting, project coordination
Preferred skills
Medical billing workflow knowledge, practice billing software expertise, state/federal/commercial payer rule knowledge, contract database management, multi-contract management
Technologies
Rivet, SHM Revenue Cycle systems
Responsibilities
Manage contract management tool and fee-related tablespaces; review and interpret payer contracts to create fee schedules; analyze reimbursement data to identify discrepancies and opportunities; compile reports for claim recovery and underbilling alerts; initiate contact with payers to validate rate discrepancies; collaborate with technology teams to enhance software solutions.
Seniority
Individual Contributor, Analyst level