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University of Mississippi Medical Center · 3 months ago

Managed Care Payment Integrity Analyst - Contract Reimbursement - Payor Contracting

Jackson, MS

Full-time, Contract

Onsite

Mid Level

3+ years exp

The University of Mississippi Medical Center is seeking a Managed Care Payment Integrity Analyst to oversee reimbursement variances from payers. The role involves monitoring payment integrity functions, interpreting contract language, and resolving discrepancies in reimbursement.

EducationHealth CareMedical

Responsibilities

Maintains strict confidentiality and adheres to all HIPAA guidelines and regulations

Focuses daily on complying with policies, processes and department guidelines for assigned managed care duties

Validate billing and payment for service is accurate

Research and understand discrepancies in reimbursement and take appropriate measures to resolve

Has a basic understanding of provider claim reimbursement; is knowledgeable and proficient with payer websites and other useful resources pertaining to revenue cycle functions

Collaborates with management and co-workers in an open and positive manner

Contributes to a positive working environment

The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive. Management retains the right to add or change duties at any time

Qualification

Provider reimbursement methodologiesHealthcare reimbursementCMS payment methodologyTransplant billing requirementsAnalytical skillsMicrosoft OfficeMedical terminologyBasic computer skillsThird-party insurance knowledgeCommunication skillsOrganizational skills