Payment Compliance and Contract Management Analyst - REMOTE

Job description

Job Summary The Payment Compliance & Contract Management (PCCM) Analyst is responsible for maximizing reimbursement by identifying variances between posted and expected revenue for managed care, government contracts, and other payers. This role includes analyzing contract compliance, identifying revenue opportunities, and communicating discrepancies to relevant departments. The PCCM Analyst collaborates with financial and clinical teams to improve revenue cycle processes and optimize payer relationships. Essential Functions: - Analyzes contract reimbursement, identifying variances, trends in underpayments/overpayments, denials, and revenue 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 revenue cycle processes. - Reviews payer policies and updates for their impact on reimbursement, co...