Job Description

Position Summary

With minimal supervision, the Revenue Integrity Payer Analyst works with, among others, the Central Billing Office, Patient Access, HIM, Compliance, and IT departments. The Revenue Integrity Payer Analyst will be responsible for reading, analyzing, and summarizing payer written communications to facilitate operational and system changes required by payers to remain compliant, improve net revenue, and reduce denials.

Key Responsibilities

  • Operationalize access to payer communications within Revenue Integrity (RI) department;
  • Read and categorize payer communication specific to topic, department, and impact;
  • Prepare weekly summary document of payer notifications to distribute to Steward Health Care Hospitals and Corporate groups that identifies the necessary change information;
  • Perform follow-up on payer changes to ensure they are implemented; and
  • Create and maintain “library” of payer notifications.

Required Knowledge and Skills

  • Working knowledge of Revenue Cycle Operations;
  • Working knowledge of CPT and diagnosis coding;
  • Working knowledge of technical and professional claim requirements;
  • Working knowledge of payer referral and authorization processes and requirements;
  • Expert knowledge in reading and understanding payer regulations;
  • Excellent communication and interpersonal skills with the ability to effectively interpret, communicate, and educate others;
  • Strong quantitative, analytical, and organizational skills;
  • Ability to respond to complex inquires in a professional and efficient manner;
  • Must be flexible and be able to adjust to changing environments, including travel to each Steward facility if needed.

Education and Experience

  • Education: Bachelor’s degree in Nursing, Accounting, Finance, Healthcare Administration, or Business Administration or 3 years of direct experience.
  • Experience (Type & Length): Minimum of 5 years’ health care experience with 3 years’ chargemaster, billing, or coding experience.
  • Certification/Licensure:
  • Software/Hardware: Proficient in MS Office suite.

Application Instructions

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