Payer Contract Analyst

Develop and optimize reporting and analysis for contract performance, reimbursement trends, and financial impact on the organization. Monitor changes in payer contracts and guidelines to educate staff and assist in implementation. Prepare reports and analyze reimbursement, utilization, and compliance issues regarding government and commercial payers. Validate payments, address billing discrepancies, and perform internal audits to ensure optimal reimbursement. Develop tools for data collection on payment models, summarize findings for internal and external audiences, and create graphical data to explain trends. Maintain expert knowledge of risk scoring, bundled payments, and Medicare guidelines while researching updated procedures and regulations.