Analyst, AR Contract

Exemption Status:

Schedule Details:

Scheduled Hours:

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This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.

At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.

I. Major Responsibilities:

1. Participates in the design, testing and implementation of third party contract models in the Hospital Billing Revenue Cycle Management system
2. Validates contract reimbursement changes, updates, and revisions have been updated properly in the Hospital Billing Revenue Cycle Management system.
3. Assists in modeling reimbursement changes. Reviews all change control recommendations with the Sr. Contract Analyst.
4. Uses payment variance data, analyzes discrepancies and performs root cause analysis. Escalates issues as appropriate.
5. Participates with the UMMHC Managed Care roundtable forums to communicate payer issues and identify resolution strategies.
6. Documents reimbursement changes and provides information to management team for the purpose of updating staff.
7. Maintains the payer contract issues log to ensure that findings and recoveries are accurately documented and communicated timely and appropriately.
8. Ensures that all required payer contract maintenance is completed on a timely basis.
9. Works with payment variance staff to understand variances and appropriate actions that need to be taken to resolve the issue.
10. Utilizes the internet and other resources to obtain payment criteria from contracted and government payers.
11. Recommends new claim edits and changes based on payer requirements.
12. Adheres to change control processes.
13. Provides training and education to the staff focusing on payer reimbursement methodology.
14. Facilitates and promotes the sharing of knowledge and content throughout departments.
15. Follows all established departmental policies and procedures.
16. Adheres to change control processes.
17. Demonstrates excellent attendance and actively participates in a variety of meetings and training sessions as required.
18. Complies with established environment of care/safety policies and procedures and all health and safety requirements.
19. Maintains and fosters an organized, clean, and safe work environment.
20. Contributes to the development and application of process improvements.
21. Maintains a collaborative, team relationship with peers and colleagues in order to effectively contribute to the group's achievement of goals and to help foster a positive work environment.
22. Demonstrates respect for the diversity of patient and employee populations. Supports and encourages diverse points of view, work, and lifestyles.
23. Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc.
24. Performs a variety of related duties as assigned by management.

Standard Staffing Level Responsibilities:

1. Complies with established departmental policies, procedures and objectives.
2. Attends variety of meetings, conferences, seminars as required or directed.
3. Demonstrates use of Quality Improvement in daily operations.
4. Complies with all health and safety regulations and requirements.
5. Respects diverse views and approaches, and contributes in maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
6. Maintains, regular, reliable, and predictable attendance.
7. Performs other similar and related duties as required or directed.

All responsibilities are essential job functions.

II. Position Qualifications:

License/Certification/Education:
Required:
1. Associated degree

Preferred:
1. Minimum of a Bachelor's degree

Experience/Skills:
Required:
1. Three to five years of experience in health care billing, reimbursement or managed care.
2. Experience with revenue cycle systems, third party contracts, payment policies, claim processes.
3. Demonstrated interpersonal skills.
4. Demonstrated ability to train others in the use of revenue cycle systems.
5. In depth knowledge of billing, reimbursement and charges.
6. Intermediate Excel skills.

Preferred:
1. Goal oriented with high standards for quality and performance.
2. Ability to perform assigned tasks efficiently and in timely manner.
3. Ability to work collaboratively and effectively with people. Exceptional communication and interpersonal skills.

Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.

Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.

III. Physical Demands and Environmental Conditions:

Work is considered sedentary. Position requires work indoors in a normal office environment.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We're striving to make respect a part of everything we do at UMass Memorial Health - for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.

As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.

If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.