Revenue Cycle Payor Analyst
Kforce
A client with Kforce is seeking a Revenue Cycle Payor Analyst to join their team. This is a hybrid opportunity with 2-3 days a week onsite on Fort Meyers, FL. Clients employees are the foundation of their success. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role.
Summary:
The Revenue Cycle Payor Analyst is responsible for ensuring the financial health of the organization by managing and optimizing the revenue cycle process. This position is responsible for handling payor-related activities, including claims submission, follow-up, denial management, and resolution of payment discrepancies. The Specialist will have a strong understanding of payor policies, billing practices, and revenue cycle workflows, with the ability to work independently and collaboratively to meet departmental goals.
Responsibilities:
* Prepare, review, and submit accurate claims to payors on time
* Monitor claims for errors, rejections, and compliance with payor requirements
* Analyze and resolve claim denials by identifying root causes and implementing corrective actions
* Prepare and submit appeals for denied claims, ensuring proper documentation and adherence to payor guidelines
* Review and reconcile payments received from payors against expected reimbursement
* Investigate and resolve payment discrepancies, including underpayments and overpayments
* Serve as the primary point of contact for payors to address claim-related inquiries and issues
* Maintain up-to-date knowledge of payor policies, procedures, and contract terms
* Ensure compliance with federal, state, and local regulations, as well as organizational policies
* Maintain accurate and detailed records of all claim activities, communications, and resolutions
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