Job Description

Location: Steward Health Care
Posted Date: 12/28/2022

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
For more information, visit www.steward.org.

Contract variance analysts are responsible for reviewing and analyzing payer contractual obligations relative to definitive agreements, as it applies to claim adjudications and reimbursements. Contract variance analysts are also responsible for interpreting contractual language in coordination with various contract management applications and resources to facilitate variance analysis/reporting. The ideal candidates demonstrate attention to detail, are self-starters but also capable of working well on a team; and can quickly comprehend key provisions of complex contractual agreements. Contract variance analysts must be able to generate ideas to solve problems and manage multiple projects simultaneously. This position reports to the Manager, Revenue Operations.

KEY RESPONSIBILITIES:

(Use bullets for specific responsibilities)

  • Perform validation of reason codes for technical overpayments as documented on the account or correspondence. (Overpayments/Underpayments based on clinical reasons will be handled by Clinical Appeals)
  • Closely monitor the ongoing portfolio of assigned contractual payers and communicate trends to leadership
  • Review transactional agreements to determine the relevant legal information and perform thorough analysis to fully understand contractual obligations.
  • Coordinate closely with contract variance team to create accurate distribution waterfall analysis and ensure claim adjudications/reimbursements are released per contractual terms.
  • Display and provide expertise in contract variance matters.
  • Resolve account discrepancies.
  • Monitor third party payer trends via assigned reports.
  • Escalate contract issues to the Manager.
  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement".
  • Supportive of the compliance program set forth by Steward Health Care System LLC as demonstrated by:

o Upholding the Code of Conduct and Corporate Compliance.

o Adhering to and helps to enforce all compliance policies relevant to his/her area.

o Assuring timely compliance education as requested by the Regional Compliance and Safety

Officer and/or through corporate initiatives.

  • Demonstrate excellent communication skills, both written and verbal.
  • Skill in time management and project management.
  • Ability to work efficiently under pressure
  • Ability to read, understand and interpret, analyze, and apply complex regulatory requirements.
  • Other duties as assigned.

REQUIRED KNOWLEDGE & SKILLS:

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

  • Communication - communicates clearly and concisely, verbally and in writing
  • Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
  • Interpersonal skills - able to work effectively with other employees, patients and external parties
  • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems
  • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
  • Contracts and Reimbursement - demonstrates knowledge and understanding of contracts and reimbursement

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: HS Diploma or GED required..
  2. Experience (Type & Length): At least one years of related experience. Relevant education may substitute experience requirement.
  3. Certification/Licensure:
  4. Software/Hardware: PC skills - demonstrates proficiency in PC applications as required.
  5. Other:

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Application Instructions

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