The Revenue Cycle Reimbursement Analyst updates, analyzes and maintains the Contract Management System and the PRM (Payer Responsibility Masterfile).
Essential Job Duties
Analyzes and interprets expected reimbursement on new and/or existing contracts for all acute care facilities
Updates either the Contract Management system or the PRM, using the Siemens system through a variety of payment methodologies including fee schedules, DRG, APC, Per-Diem, Case Rates, Percentage of Charges and/or Outlier Reimbursement
Loads and verifies accuracy of Medicare/Medicaid reimbursement for several states
Maintains all system wide Financial Classes, Insurance Plan Codes and Transaction Codes
Performs quality reviews on all updates of reimbursement methods for all payers and manages daily workflow thru UHS Incident Ticketing System.
Educates other UHS employees, Facilities, CBOâ€™s on contract, payer or regulatory changes and/or enhancements
Reviews payment variance reports, contractual allowance reports and reimbursement reports to identify trends, educational needs, payer issues, AR and/or workflow problems and/or potential system issues
Performs quality reviews on all system updates to the reimbursement ACCESS database for all payers to assure contracts are received and revised in a timely mannerÂ Â