Title: Payment Variance Analyst I
Hours: 40 hours per week; Monday through Friday.
Location: Open to remote work or a hybrid model at 55 Technology Drive in Lowell, MA
Job Overview
The position, under the supervision of the Manager of Hospital Billing, performs extensive analysis and various follow\-up activities to ensure the integrity of reimbursement of medical services provided by the hospital. Responsibilities include identifying payment variances and working internally and externally to resolve such issues and recover underpayments.
Job Description
Minimum Qualifications:
1\. Associates degree and five (5\) years of provider billing and revenue cycle experience OR High school diploma or equivalent and seven (7\) years of provider billing and revenue cycle experience
Preferred Qualifications:
1\.Basic\-level Excel skills
2\.One (1\) year of Epic experience
Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all\-inclusive list. Other duties and responsibilities may be assigned.
1\.Identifies and analyzes payment variances, working closely with third party payers to resolve issues and ensure correct reimbursement.
2\.Recovers underpayments.
3\.Work with other hospital departments on issues related to payment integrity.
4\.Analyzes and gathers supporting documentation to process appeals to third parties, and follow up with payers accordingly.
5\.Performs research and analysis related to billing and reimbursement.
6\.Maintains current knowledge in the areas of third party billing, reimbursement schedules and methodologies, coding, payer contracts, billing and payment rules and regulations, and hospital billing compliance.
7\.Assists with special projects as assigned.
Skills \& Abilities
1\.Analytical and research skills.
2\.Working knowledge of medical terminology and coding, including CPT, DRG, Revenue Codes, and ICD\-10 codes.
3\.Experience working with third party payers to resolve ongoing issues.
4\.Basic knowledge of billing guidelines, rules, and payment policies.
5\.Strong verbal and written communication skills.
6\.Adequate time management and organizational skills.
7\.Experience working with computer systems and programs.
Job Profile Summary
This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Revenue Integrity duties: Responsible for compliantly maximizing financial reimbursement for clinical services provided to patients. Identifies financial reimbursement degradation, maintaining fee schedules, etc. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non\-clinical) operating in a “hands on” environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation.
At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day.
The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals.
Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it.
Pay Range:
$66,397\.24 \- $82,991\.27