Position Details

Type Full-Time

Experience mid

Exp. Years 5+ years

Education Not specified

Category Finance & Accounting

About this role

Payer Reimbursement Analyst responsible for reviewing payer contracts and payment policies, creating summaries, and guiding reimbursement initiatives to maximize timely and accurate reimbursement across ASC operations.

Key Responsibilities

Ensures Managed Care Contracts are loaded timely and accurately into the appropriate systems
Provides contract summaries, highlighting payer methodologies, rates, and key areas for accurate claims processing
Create, disseminate, and participate in educational materials related to contracts and reimbursement strategy
Leads payer-specific training of new hires and ongoing payer education
Stay current on industry trends and best practices aligned with reimbursement strategies

Technical Overview

Focus on contract administration, reimbursement policies, and revenue cycle with proficiency in Microsoft Office and reimbursement software Vision/AdvantX.

Ideal Candidate

The ideal candidate has extensive ASC contracts and reimbursement experience, with deep knowledge of Medicare/Medicaid and payer guidelines. They are detail-oriented, analytically skilled, and proficient with Microsoft Office and reimbursement software to optimize revenue cycle performance.

Must-Have Skills

This position requires extensive experience in understanding Ambulatory Surgical Center contracts and reimbursement.Extensive knowledge of health insurance plans (MedicareMedicaidManaged CarePPOPOSSelf-fundedTPAsWorkers Competc.).Vast knowledge and technical competence in Contract Administration.Knowledge of typical payer guidelines related to billingboth paper and electronic claimsUnderstanding of revenue cycle processescause and effect on A/R and cash resultsExcellent written and verbal communication skills.Proficient knowledge WordExcelPowerPointand OutlookExperience with Vision and/or AdvantX software is helpful.

Nice-to-Have Skills

Vision and AdvantX experienceASC reimbursement process optimization

Tools & Platforms

Microsoft WordMicrosoft ExcelMicrosoft PowerPointOutlookVisionAdvantX

Required Skills

Ambulatory Surgical Center contractsreimbursementMedicare/Medicaidcontract administrationpayer guidelinesrevenue cycleLCDsVisionAdvantXWordExcelPowerPointOutlook

Hard Skills

Ambulatory Surgical Center contractsreimbursementMedicare and Medicare policiescontract administrationpaper and electronic claimsrevenue cycle processesdata analysisWordExcelPowerPointOutlookVisionAdvantX

Soft Skills

written and verbal communicationattention to detailproblem solvingability to work independentlyteam collaboration

Industry & Role

Industry Healthcare & Medical

Job Function Manage ASC payer contracts and reimbursement processes to maximize accurate and timely reimbursement

Role Subtype Finance & Accounting

Tech Domains Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Outlook, Vision, AdvantX

Keywords for Your Resume

payer reimbursement analystAmbulatory Surgical Center contractsMedicareMedicaidManaged CarePPOPOSSelf-fundedTPAsWorkers Compcontract administrationrevenue cyclelcdsVisionAdvantXWordExcelPowerPointOutlookclaims processingLCDs

Deal Breakers

Lack of experience with ASC contracts and reimbursement, Inadequate knowledge of Medicare/Medicaid and payer rules

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