Hospital Revenue Cycle Analyst – Contract Reimbursement
Plano, TX
Category: Healthcare
Reference ID: 10082432
Shortcut: http://addisongroup.gosnaphop.com/uExyZa
Job Title: Hospital Revenue Cycle Analyst – Contract Reimbursement
Location: Remote (San Antonio, TX residents only)
Pay: $25.00 – $27.00 / Per hour
Benefits: This position is eligible for medical, dental, vision, and 401(k).
Position Overview
Addison Group is hiring for our client, an established healthcare organization, seeking an experienced Hospital Revenue Cycle Analyst to support revenue accuracy, payer contract reimbursement, and account auditing.
This position focuses on ensuring hospital accounts are billed and reimbursed correctly according to contracted rates, fee schedules, and payer agreements.
The ideal candidate has a strong understanding of hospital billing, UB-04 claims, payer contracts, reimbursement methodologies, and payment variance analysis. This is a highly analytical role requiring strong Excel skills, mathematical accuracy, and the ability to identify and resolve revenue discrepancies.
Key Responsibilities
- Review hospital accounts to ensure charges, payments, and balances are accurate
- Verify insurance information and confirm appropriate payer contracts are applied
- Compare contracted reimbursement rates against actual insurance payments
- Analyze fee schedules, per diem rates, and other reimbursement methodologies
- Identify and research underpayments, overpayments, and account variances
- Review Explanation of Benefits (EOBs) to validate reimbursement
- Audit accounts before billing, throughout the billing process, and after payment
- Research billing discrepancies and determine appropriate corrections
- Prepare and follow up on underpayment appeals based on payer contract terms
- Complete account adjustments, contract overrides, and corrected pricing as needed
- Review credit balances and assist with refund processing
- Reconcile exception reports and resolve outstanding discrepancies
- Support month-end reconciliation, reporting, and revenue accuracy reviews
- Maintain accurate payer information, reimbursement rates, and account documentation
- Analyze revenue data using Excel and identify trends impacting reimbursement
- Collaborate with Revenue Cycle, Finance, and Managed Care teams to resolve contract and payment issues
Qualifications
- Hospital Revenue Cycle, billing, or collections experience required
- Experience reviewing payer contracts, fee schedules, per diem rates, and reimbursement terms
- Knowledge of UB-04 hospital claims
- Strong understanding of insurance reimbursement and payment methodologies
- Experience reading and interpreting Explanation of Benefits (EOBs)
- Ability to identify and calculate payment variances, underpayments, and overpayments
- Strong mathematical and analytical skills
- Proficiency with Microsoft Excel
- Experience researching account discrepancies and resolving reimbursement issues
- Strong attention to detail and accuracy
- Ability to manage multiple priorities in a fast-paced environment
Preferred Qualifications:
- Experience with WellSky
- Hospital contract reimbursement or revenue integrity experience
- Experience with payment variance analysis and underpayment appeals
- Knowledge of payer contract adjustments and account reconciliation
- Experience supporting month-end revenue reporting or audits
Ideal Candidate
We are looking for someone who enjoys working with numbers, investigating discrepancies, and ensuring hospital accounts are reimbursed accurately.
The strongest candidates will be able to review a hospital claim, understand the applicable payer contract, calculate the expected reimbursement, and identify why an account may have been paid incorrectly.
This person should be:
- Highly analytical with strong math skills
- Detail-oriented and committed to accuracy
- Comfortable working extensively in Excel
- A quick learner who can adapt to changing processes
- Proactive in identifying and resolving reimbursement discrepancies
- Organized and able to work independently
- Comfortable managing deadlines in a fast-paced Revenue Cycle environment
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran, in accordance with applicable federal, state, and local laws. Reasonable accommodation is available for qualified individuals with disabilities upon request.
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