Apply on Employer Site

Community Health Systems · 2 weeks ago

Payment Compliance and Contract Management Analyst - REMOTE

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

Community Health Systems is one of the nation’s leading healthcare providers, committed to helping people get well and live healthier. The Payment Compliance & Contract Management (PCCM) Analyst is responsible for maximizing reimbursement by analyzing contract compliance and identifying revenue opportunities, while collaborating with financial and clinical teams to improve revenue cycle processes.

Health CareHospital

Responsibilities

Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and revenue leakage to support maximization of reimbursement

Manages underpayment appeals and account follow-up, working collaboratively with payers and internal teams to resolve discrepancies in a timely manner

Interprets contract terms, validates compliance, and provides feedback to management and departments to ensure accurate reimbursement processes

Compiles, analyzes, and presents data on payment trends, making recommendations for improvements in revenue cycle processes

Reviews payer policies and updates for their impact on reimbursement, communicating changes to appropriate teams to ensure compliance

Develops and maintains reports that identify payment discrepancies, revenue opportunities, and performance metrics for management review

Collaborates with financial, clinical, and operational teams to address contract compliance issues and enhance payer relations

Maintains knowledge of medical coding systems, reimbursement structures, and regulatory changes to support accurate account adjudication

Performs other duties as assigned

Maintains regular and reliable attendance

Complies with all policies and standards