Professional Revenue Analyst

Department: Clinical Affairs - YMA Specialty and Payer Management 221 Whitney Ave, New Haven, Connecticut Job ID: 136034WD $68,000.00 - $120,500.00 Description ---------------

Working at Yale means contributing to a better tomorrow. Whether you are a current resident of our New Haven-based community, eligible for opportunities through the New Haven Hiring Initiative, or a newcomer, interested in exploring all that Yale has to offer, your talents and contributions are welcome. Discover your opportunities at Yale!

Overview

Under the direction and supervision of the Professional Revenue Profile Variance Manager, or his/her designee, analyzes professional revenue data specific to Pricing, Claims Reimbursement and Integrity of Payer Contract Management for Yale Medicine. Responsible for ensuring the accuracy of payer fee schedules, system logic and routine maintenance to reduce payment variances. Performs reliable and timely analysis of incorrect payments to ensure maximum recoveries for all carriers. Following through with payment issues until resolution when identifying and escalating payment trends. Through detailed data mining and analysis, monitors and reports on payer contract performance to support contracting objectives. collaborates with and supports Specialty and Payor Liaisons with report generation and analysis of departmental billing and collection activity.

Required Skills and Abilities

1. Exceptional ability to produce, analyze and interpret detailed reports, develop clear conclusions, and summarize and present findings; monitor and analyze payer key performance metrics for YM and individual clinical departments. Working knowledge of EPIC or other Practice Management and Electronic Health Record applications, including knowledge of contract management systems.

2. Exceptional ability to analyze and evaluate documented policies, procedures and operational workflows and recommend process improvements to maximize workflo...