Contract Payer Analyst - Hybrid - Must live in Colorado
Company: Denver Health
Location: Denver
Posted on: March 14, 2025
Job Description:
We are recruiting for a motivated Contract Payer Analyst -
Hybrid - Must live in Colorado to join our team!
We are here for life's journey.
Where is your life journey taking you?
Being the heartbeat of Denver means our heart reflects something
bigger than ourselves, something that connects us all:
Humanity in action, Triumph in hardship, Transformation in
health.DepartmentPayer ContractingJob Summary
Under the general supervision of the Contract Payer Manager, the
Payer Contract Analyst is responsible for overseeing and managing
all Payer contracts on behalf of Denver Health & Hospital
Authority. The Payer Contract Analyst reviews and manages all payer
contract terms for both internal and external stakeholders. This
position works closely with the Contract Payer Manager to ensure
processes are in place and contractual measures are met. The Payer
Contract Analyst collaborates with internal and external
stakeholders to understand payer specific data, contractual
requirements and operational issues.
Essential Functions:
- Develops and maintains contract management resources and tools.
(10%)
- Builds and manages the contract management software system for
the department. (10%)
- Accurately enters contract-related data into contract
management system to maintain and manage contract records and
monitor contract compliance. (10%)
- Ensures all resources are updated with the new contract
information and the new information is communicated to all
appropriate staff prior to contract effective date. (10%)
- Interprets third party payer contract language and understands
contract details and the major provisions of agreements as they
relate to day to day operations (e.g. timely filing limits,
refunds, rate schedules, term notices, facility credentialing
requirements, etc.). (10%)
- Develops strong relationships with internal and external
customers and serves as an escalation point between third party
payers and internal departments such as Revenue Cycle,
Registration, Patient Access and Medical Staff Office to resolve
issues related to contracting, billing, payments, registration and
provider roster issues. (5%)
- Negotiates single case agreements to capture financial
reimbursement from non-contracted entities. (5%)
- Assists in specific contract negotiations, financial modeling
and contract follow up for special projects. (5%)
- Ensures the department possesses relevant knowledge of Payer
Enrollment requirements of various third party payers, Medicare and
Medicaid, and maintains the delegated payer credentialing status.
(5%)
- Collaborates with Medical Staff Office to collect and submit
accurate information for the provider directories; updates, audits
and sends provider rosters to commercial payers in compliance with
NCQA standards. (5%)
- Oversees, updates and maintains provider credentialing
databases, such as CAQH. (5%)
- Maintains Denver Health facility and clinic credentialing with
third party payers.. (5%)
- Promotes professional growth and development through leadership
activities and continuing education and training. (5%)
- Maintains involvement in local/regional/national professional
organizations. (5%)
- Maintains current knowledge of payer and market industry
changes and trends and communicates results to the department and
other staff. (5%)
Education:
- Bachelor's Degree Business Administration, Health Care
Administration, or related health care field. Required
Work Experience:
- 4-6 years Minimum five or more years of recent healthcare,
insurance or practice management experience. Required and
- 1-3 years Minimum three years of contract management
experience. Required
Licenses:
Knowledge, Skills and Abilities:
- Strong knowledge of Managed Care contracts is required.
Advanced understanding of CPT, HCPCS, ICD-10 and various
reimbursement methodologies such as Medicare/ Medicaid and third
party billing requirements. Extensive knowledge and experience with
Medicare/ Medicaid regulations.
- Excellent verbal and written communication, leadership,
delegation, collaboration and interpersonal skills.
- Strong working knowledge of billing and collection processes
and functions, general revenue cycle management strategies and
industry best practices.
- Detail Oriented and have a strong ability to multi-task with
ability to exercise judgment in differing situations.
- Utilizes software applications and working knowledge of the
following information systems to include accessing information,
updating, correcting and/ or deleting data. General knowledge
related to various software applications and their capabilities.
Microsoft Office applications: Word, Excel, Access, PowerPoint and
Outlook and other applications as needed.
- Ability to be resourceful, customer-service oriented and
independently problem-solve is required.
- Ability to independently define problems and develop relative
solutions, collect data, establish facts, and draw valid
conclusions.
- Proficient in Microsoft Word and Excel with excellent computer
skills.ShiftDays (United States of America)Work
TypeRegularSalary$60,314.00 - $87,695.00 / yrBenefits
- Outstanding benefits including up to 27 paid days off per year,
immediate retirement plan employer contribution up to 9.5%, and
generous medical plans
- Free RTD EcoPass (public transportation)
- On-site employee fitness center and wellness classes
- Childcare discount programs & exclusive perks on large brands,
travel, and more
- Tuition reimbursement & assistance
- Education & development opportunities including career pathways
and coaching
- Professional clinical advancement program & shared
governance
- Public Service Loan Forgiveness (PSLF) eligible employer+ free
student loan coaching and assistance navigating the PSLF
program
- National Health Service Corps (NHCS) and Colorado Health
Service Corps (CHSC) eligible employerOur Values
- Respect
- Belonging
- Accountability
- TransparencyAll job applicants for safety-sensitive positions
must pass a pre-employment drug test, once a conditional offer of
employment has been made.
Denver Health is an integrated, high-quality academic health care
system considered a model for the nation that includes a Level I
Trauma Center, a 555-bed acute care medical center, Denver's 911
emergency medical response system, 10 family health centers, 19
school-based health centers, Rocky Mountain Poison & Drug Safety, a
Public Health Institute, an HMO and The Denver Health
Foundation.
As Colorado's primary, and essential, safety-net institution,
Denver Health is a mission-driven organization that has provided
billions in uncompensated care for the uninsured. Denver Health is
viewed as an Anchor Institution for the community, focusing on
hiring and purchasing locally as applicable, serving as a pillar
for community needs, and caring for more than 185,000 individuals
and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away
from many of the cultural and recreational activities Denver has to
offer.
Denver Health is an equal opportunity employer (EOE). We value the
unique ideas, talents and contributions reflective of the needs of
our community.Applicants will be considered until the position is
filled.Required
Keywords: Denver Health, Denver , Contract Payer Analyst - Hybrid - Must live in Colorado, Professions , Denver, Colorado
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