Apply on Employer Site

Mercyhealth Wisconsin and Illinois · 1 month ago

Revenue Cycle Reimbursement Analyst

United States

Full-time

Remote

Mid Level

3+ years exp

Mercyhealth is a healthcare provider operating in Wisconsin and Illinois, and they are seeking a Revenue Cycle Reimbursement Analyst. This role involves analyzing payor contracts and variances, maximizing reimbursements, and providing training and guidance to team members on revenue cycle issues.

Health CareNon Profit

Responsibilities

Interpret and understand coverage and benefit limitations by having a comprehensive understanding of benefits and state requirements for multiple markets

Identify trends and suggest and develop efficiencies in the revenue cycle through review and trending of payer contracts and reimbursement trends

Research and trends denials from payors

Reads through healthcare contracts and contract language and ensures proper contract workflows

Researches remittances and Explanation of Benefits (EOBs) for complete accurate payments or denials

Work with payers to understand specific reasons for variances and/or denials and measures to prevent future denials

Research payer policies and requirements and utilize knowledge to determine whether an appeal is required and to get claims overturned

Develop sound and well-supported appeal arguments, where an appeal is warranted

Submits corrected claims and appeals

Coordinates appeals with clinical or coding areas within the revenue cycle

Requests appropriate adjustments, when required

Provide training and guidance to team members on market specific issues by providing feedback to management on claims and provider issues, and updating client business rules

Partner with Reimbursements team to assist in completing all other tasks as necessary to ensure accurate and timely internal turnaround times

Qualification

Revenue cycle managementDenials managementContract managementHealthcare contracts analysisTeam training

Required

Associate's degree in finance, business, or healthcare administration and 3 years' experience working in revenue cycle, denials management and contract management required

5 years of experience in lieu of degree

Benefits

Comprehensive Benefits Package: Mercyhealth offers a retirement plan with competitive matching contribution, comprehensive medical, dental, and vision insurance options, life and disability coverage, access to flexible spending plans, and a variety of other discounted voluntary benefit options.

Competitive Compensation: Mercyhealth offers market competitive rates of pay and participates in various shift differential and special pay incentive programs.

Paid Time Off: Mercyhealth offers a generous paid time off plan, which increases with milestone anniversaries, to allow employees the opportunity for a great work-life balance.

Career Advancement: Mercyhealth offers a number of educational assistance programs and career ladders to support employees in their educational journey and advancement within Mercyhealth.

Employee Wellbeing: Mercyhealth has a focus on wellbeing for employees across the organization and offers a number of tools and resources, such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey.

Additional Benefits: Mercyhealth employees have access to our internal and external employee assistance programs, employee-only discount packages, paid parental and caregiver leaves, on-demand pay, special payment programs for patient services, and financial education to help with retirement planning.