[Remote] Payment Contract Analyst - Healthcare Revenue Cycle - Remote
Note: The job is a remote job and is open to candidates in USA. Tennova Healthcare - North Knoxville Medical Center is a leading healthcare provider committed to helping people get well and live healthier. The Payment Compliance & Contract Management (PCCM) Analyst will maximize reimbursement by analyzing contract compliance and collaborating with teams to improve revenue cycle processes.
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.
Skills
• H.S. Diploma or GED required
• 2-4 years of experience in revenue cycle management, contract compliance, or healthcare reimbursement analysis required
• Strong understanding of managed care, government contracts, and reimbursement processes.
• Proficiency in data analysis, with the ability to compile and interpret complex data sets related to contract compliance and payment trends.
• Excellent communication and interpersonal skills for working with internal teams and external payer representatives.
• Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG, etc.) and how they affect claim adjudication.
• Strong organizational skills, with the ability to manage multiple projects and deadlines.
• Proficient in Google and Microsoft Office Suite, with intermediate to advanced Excel skills.
• Associate Degree or higher preferred
Benefits
• Medical, dental and vision, insurance
• 401k
Company Overview
• North Knoxville Medical Center is an acute care hospital. It was founded in undefined, and is headquartered in Powell, Tennessee, US, with a workforce of 501-1000 employees. Its website is https://www.tennovanorthknoxville.com/.
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