SENIOR FINANCIAL ANALYST:
Montefiore Medical Center

88041-en_US
Montefiore Medical Center
Yonkers New York
Healthcare
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Description

Overview : The Payment Variance Analyst will play a key role in the Payment Variance team by reviewing claim and payment information through the Experian Contract Management system to identify potential individual underpayments and underpayment trends. Identified potential underpayments and trends will be analyzed and screened to remove false positives, enabling other team members to accurately and efficiently pursue lost revenue. 
 

Responsibilities:

  • Makes use of high volume reports to review historical payment information and determine the accuracy of reimbursements for a specific subsection of Payors.
  • Reviews physician fee schedules and contracts to determine appropriate application of rates, provisions and terms
  • Identifies potential underpayment trends through comparison of contracts to actual reimbursement information via contract management technology
  • Applies analytical techniques during report review to remove inaccurate information and potential false positive returns
  • Investigates third party payor policies and contracts to verify accuracy of underpayment variances according to published payor guidelines
  • Identifies and suggests action plan for resolution of contract management system (Experian) issues
  • Reports underpayments and underpayment trends to management and audit team for pursuit and collection
  • Assigns claims to be worked by appropriate Billing Specialists
  • Meets productivity standards established by Management team

 

Qualifications:

  • BA/BS in business or related concentration
  • Minimum 3 years' experience in healthcare operations and data
  • Proven knowledge and experience in managed care contracts
  • Demonstrated ability to work in a team environment that requires quick turnaround and quality output.
  • Solid knowledge of all MS Office Products.
  • Strong analytical acumen
  • Excellent oral and written communication skills
  • Clinical experience in areas of the Operating Room, Materials Management, Laboratory, Nursing or other clinical areas

 

 

 

 

 

Department: Professional Services Reimbursement Analysis Unit Bargaining Unit: Non Union Campus: Yonkers  Address: 3 Executive Blvd.
Shift: Day Scheduled Hours: 8:30 AM - 5:00 PM Req ID: 88041

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

Basic Qualifications
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