Payment Variance Specialist

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    "ExternalDescriptionStr": "<p><span>Payment Variance Specialist Park Nicollet is looking to hire a<strong>&nbsp;</strong>Payment Variance Specialist to join our team!&nbsp;Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day.&nbsp;</span></p><p><span><strong><u>Position Summary:</u></strong></span></p><p><span style=\"background-color: white; color: black;\"><span class=\"normaltextrun\">The Payment Variance Specialist performs day-to-day payment variance activities, researching payment policies and reviewing potential payment variances on both facility and professional accounts. Serves as part of the Payment Variance team responsible for ensuring proper claims payments are received from insurance companies, determining root causes for discrepancies, minimizing inappropriate payment delays and variances from expected reimbursement, and resolving or escalating issues when necessary. This role will work with payers directly to ensure reimbursements are aligned with negotiated contracts. Use internal data and systems to identify, document, track and summarize payment variances to determine appropriate actions to be taken to initiate appeals and address inaccurate reimbursement in a timely manner.</span><span class=\"eop\">&nbsp;</span></span></p><p><span><strong><u>Required Qualifications:</u></strong></span></p><p style=\"margin-bottom: 6pt;\"><span><strong>Education, Experience or Equivalent Combination:</strong></span></p><ul><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Minimum 3 years of experience in combined/comprehensive contract variance review/analysis, healthcare claims billing and/or collections, or any combination of experience listed. &nbsp;</span></p></li></ul><p style=\"margin-bottom: 6pt;\"><span><strong>Knowledge, Skills, and Abilities:</strong></span></p><ul style=\"padding-left: 48px;\"><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">Working knowledge of payer reimbursement methodologies, skilled in troubleshooting payment variances while reviewing payer policies related to reimbursement.</span></span></p></li><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">Excellent communication skills, both written and verbal that present clear and concise information to a diverse audience. &nbsp;</span></span></p></li><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">​Strong accuracy, attention to detail and time management skills.&nbsp;</span></span></p></li><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">​Advanced understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.&nbsp;</span></span></p></li><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">​Research and analytically oriented in work and analyses completed.&nbsp;</span></span></p></li><li><p class=\"paragraph\" style=\"background-color: white; margin-bottom: 0in; margin-right: 0in; margin-top: 0in; vertical-align: baseline;\"><span style=\"color: black; font-family: Calibri, sans-serif;\"><span class=\"normaltextrun\" style=\"font-size: 11pt;\">​Ability to work well with ambiguity and continuous change</span></span></p></li></ul><p><span style=\"text-decoration: none;\"><strong><u>&nbsp;</u></strong></span></p><p><span><strong><u>Preferred Qualifications:</u></strong></span></p><p style=\"margin-bottom: 6pt;\"><span><strong>Education, Experience or Equivalent Combination:</strong></span></p><ul><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">5 years of healthcare experience specifically Epic workflow processes</span></p></li></ul><p style=\"margin-bottom: 6pt;\"><span><strong>Licensure/ Registration/ Certification:</strong></span></p><ul><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Healthcare Financial Management Association (HFMA) – Certified Revenue Cycle Representative (CRCR) </span></p></li></ul><p style=\"margin-bottom: 6pt;\"><span><strong>Knowledge, Skills, and Abilities:</strong></span></p><ul><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Detailed knowledge of CPT-4, HCPCS, revenue codes and ICD-10 CM.&nbsp;</span></p></li><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Knowledge of healthcare regulations and compliance requirements.&nbsp;</span></p></li><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Demonstrated experience with administrative and clinical denial codes and appeal requirements.&nbsp;</span></p></li><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Experience with Epic Denial workflows and work queue management. &nbsp;</span></p></li><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Experience with large commercial payers and contracts.&nbsp;</span></p></li><li><p style=\"margin-bottom: 6pt;\"><span class=\"normaltextrun\">Detailed knowledge of reimbursement schemes for predominant payors.&nbsp;</span></p></li></ul><p><span><strong><u>Benefits:</u></strong></span></p><p><span>Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!</span></p>",
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