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Payer Integrity Analyst

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Leadership
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HSHS St. John's Hospital, Springfield IL
📅
19000158 Requisition #
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Position Summary
The Payer Integrity Analyst will review, research and analyze payment variance trends on claim denials and other claims processing matters for assigned payers.  The analyst will evaluate and validate claim issues and track and report on all accounts related to incorrect payer claims processing.   Creates summary documentation to present in payer the Joint Operation Committee meetings. Facilitates a strong working relationship with internal and external stakeholders to ensure that the workflow and processes are correct and working properly. Assists stakeholders in all necessary functions for analyzing payer performance and providing reports to track and quantify trending payer issues. Follows through to ensure issues are corrected and payments are accurate.  Creates and assists with filing appeals according to payer specifications.

 

Education
High School Diploma or equivalent-Required
Associates degree in related field-Preferred

 

Experience
5 years’ experience in Patient Financial Services and/or Managed Care- Required
Experience with analyzing payer and collection issues and strategizing on methods to reduce these issues - Preferred

 

Certificates, Licenses & Registrations
N/A


HSHS and affiliates is an Equal Opportunity Employer (EOE).

 

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