Payment Variance RC - PFS Account Resolution

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

The Contract Variance Analyst researches closed-balance accounts for over/under amounts due from/to payors per established contracts. The Specialist ensures payments are made properly and in full per contractual agreements identifying and reporting payor trends thru established guidelines. This position also coordinates; transfers and communication of accounts with insurance balances to the appropriate outside agency, per department guidelines.

Required Minimum Education

• High School Diploma or equivalent

Required Minimum Experience

• Two years hospital collection experience

Required Minimum Skills

• Demonstrate proficiency in reading UB04
• Demonstrate knowledge and proficiency of claims resolution
• Demonstrate ability to access Major payer(s) specific provider websites for claim corrections
• Demonstrate proficiency in locating and interpreting contract verbiage for timely claims resolution
• Demonstrate proficiency in contract management and expected reimbursement technology
• Demonstrate knowledge of billing rules
• Two years' experience with a Hospital Information System or PC-based applications
• Ability to perform mathematical calculations
• Excellent communication skills when dealing with patients, families, public, and co-workers
• Basic knowledge of medical terminology
• Detail-oriented, good organizational skills, and ability to be self-directed
• Ability to learn quickly and meet continuous timelines
• Strong time management skills, managing multiple priorities and workload in a high-stress atmosphere
• Demonstrated flexibility to perform other tasks as needed in an active work environment
• High-level problem solving, analytical, and investigational skills
• Excellent internal/external customer service skills
• Excellent communication skills to include oral and written comprehension and expression
• Ability and willingness to exhibit behaviors consistent with principles of excellent service
• Ability to demonstrate and maintain competency as required for job title and area(s) of assignment