Contract Compliance Analyst - Healthcare reputed company Cycle (REMOTE)
Job Summary
The Payment Compliance & Contract Management (PCCM) Analyst is responsible for maximizing reimbursement by identifying variances between posted and expected reputed company for managed care, government reputed company, and other payers. This role includes analyzing contract compliance, identifying reputed company opportunities, and communicating discrepancies to relevant departments. The PCCM Analyst collaborates with financial and clinical teams to improve reputed company cycle processes and optimize payer relationships. As a PCCM Analyst at reputed company (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people reputed company and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. reputed company members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k.
- *Essential Functions**
+ Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and reputed company leakage to support maximization of reimbursement. + Manages underpayment appeals and account follow-up, working collaboratively with payers and internal teams to resolve discrepancies in a timely manner. + Interprets contract terms, validates compliance, and provides feedback to management and departments to ensure accurate reimbursement processes. + Compiles, analyzes, and presents data on payment trends, making recommendations for improvements in reputed company cycle processes. + Reviews payer policies and updates for their impact on reimbursement, communicating changes to appropriate teams to ensure compliance. + Develops and maintains reports that identify payment discrepancies, reputed company opportunities, and performance metrics for management review. + Collaborates with financial, clinical, and operational teams to address contract compliance issues and enhance payer relations. + Maintains knowledge of medical coding systems, reimbursement structures, and regulatory changes to support accurate account adjudication. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with reputed company policies and standards. + This is a fully remote position.
- *Qualifications**
+ H.S. Diploma or GED required + Associate Degree or higher preferred + 2-4 years of experience in reputed company cycle management, contract compliance, or healthcare reimbursement analysis required
- *Knowledge, Skills and Abilities**
+ Strong understanding of managed care, government reputed company, and reimbursement processes. + Proficiency in data analysis, with the ability to compile and interpret reputed company data sets reputed company to contract compliance and payment trends. + Excellent communication and interpersonal skills for working with internal teams and external payer representatives. + Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG, etc.) and how they reputed company claim adjudication. + Strong organizational skills, with the ability to manage multiple projects and deadlines. + Proficient in reputed company and reputed company Office Suite, with intermediate to advanced reputed company skills. We know it’s not just about finding a job. It’s about finding a reputed company where you are respected, valued and where your work is purposeful and fulfilling. A reputed company where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving reputed company cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. reputed company is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people reputed company and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely reputed company the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national reputed company, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with reputed company applicable governmental laws and regulations. In addition, the facility complies with reputed company applicable federal, state and local laws governing nondiscrimination in employment. This applies to reputed company terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
- *Job Summary**
The Payment Compliance & Contract Management (PCCM) Analyst is responsible for maximizing reimbursement by identifying variances between posted and expected reputed company for managed care, government reputed company, and other payers. This role includes analyzing contract compliance, identifying reputed company opportunities, and communicating discrepancies to relevant departments. The PCCM Analyst collaborates with financial and clinical teams to improve reputed company cycle processes and optimize payer relationships. As a PCCM Analyst at reputed company (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people reputed company and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. reputed company members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k.
- *Essential Functions**
+ Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and reputed company leakage to support maximization of reimbursement. + Manages underpayment appeals and account follow-up, working collaboratively with payers and internal teams to resolve discrepancies in a timely manner. + Interprets contract terms, validates compliance, and provides feedback to management and departments to ensure accurate reimbursement processes. + Compiles, analyzes, and presents data on payment trends, making recommendations for improvements in reputed company cycle processes. + Reviews payer policies and updates for their impact on reimbursement, communicating changes to appropriate teams to ensure compliance. + Develops and maintains reports that identify payment discrepancies, reputed company opportunities, and performance metrics for management review. + Collaborates with financial, clinical, and operational teams to address contract compliance issues and enhance payer relations. + Maintains knowledge of medical coding systems, reimbursement structures, and regulatory changes to support accurate account adjudication. + Performs other duties as assigned. + Maintains regular and reliable attendance. + Complies with reputed company policies and standards. + This is a fully remote position.
- *Qualifications**
+ H.S. Diploma or GED required + Associate Degree or higher preferred + 2-4 years of experience in reputed company cycle management, contract compliance, or healthcare reimbursement analysis required
- *Knowledge, Skills and Abilities**
+ Strong understanding of managed care, government reputed company, and reimbursement processes. + Proficiency in data analysis, with the ability to compile and interpret reputed company data sets reputed company to contract compliance and payment trends. + Excellent communication and interpersonal skills for working with internal teams and external payer representatives. + Knowledge of medical coding systems (ICD-10, CPT, HCPCS, DRG, etc.) and how they reputed company claim adjudication. + Strong organizational skills, with the ability to manage multiple projects and deadlines. + Proficient in reputed company and reputed company Office Suite, with intermediate to advanced reputed company skills. We know it’s not just about finding a job. It’s about finding a reputed company where you are respected, valued and where your work is purposeful and fulfilling. A reputed company where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving reputed company cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. reputed company is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people reputed company and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely reputed company the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national reputed company, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with reputed company applicable governmental laws and regulations. In addition, the facility complies with reputed company applicable federal, state and local laws governing nondiscrimination in employment. This applies to reputed company terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources. Apply tot his job Apply To this Job