Cape Cod Healthcare · 4 hours ago
Analyst, Payment Variance (Hybrid)
Massachusetts-Hyannis
Full-time
Hybrid
Entry Level
1+ years expCape Cod Healthcare is a healthcare organization seeking an Analyst for Payment Variance. The role involves troubleshooting payment variances, collaborating with department managers, and ensuring compliance with billing practices.
Health Care
Responsibilities
Troubleshoot and evaluate work product of staff, make recommendations to management and implement changes
Participate with management in strategizing for Process Improvement initiatives
Attend and participate in management meetings
Work with management on special organizational projects for CCH
Participate in and provide input and feedback for employee evaluations
Works with managed care contracting, Patient financial services, software vendors, third party payer payers to identify root cause of payment variances and address and make appropriate changes to resolve payment variances
Resolves payment variance issues and ensures that the hospital is reimbursed correctly according to the contract terms
Monitors and audit payment variance software to ensure contracts are properly loaded and payment calculations are correct
Review payment variance reports for accuracy
Analyze payment transactions and identify trends using Payment Variance Software, Websites and other online communications. Identify missing charges and work with Clinical Departments, Physician Clinics and Practices to develop new charges
Collaborate with department managers and staff to review documentation supporting charge capture, identify areas of deficiency and develop process improvement programs to support compliant billing
Assist the Senior Clinical Manager in developing ongoing educational programs on charge capture and reconciliation for department managers and their staff
Develops and deliver organized, concise yet thorough communications to management, Sr. Leadership, and other departments regarding proposed, deficiencies, developments and opportunities affecting the Organization with regard to charge capture and payment variances
At the request of clinical department managers, attend staff meetings to present identified problems and solutions related to payment variance, reconciliation and documentation
Working with department managers, develop and revise tools for documenting departments’ processes for charge capture and reconciliation to prevent payment variances. Assure that all tools are reviewed and revised periodically. Monitor CCH intranet website to assure posted documents reflect current processes
Using knowledge of CDM, coding and billing, collaborate with MIS, Revenue Cycle Team and Medical Records (HIM) managers, supervisors and staff to identify and document best practices for CCH charge capture
Maintain professional affiliations and attend seminars, conferences, etc
Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job knowledge and state guidelines
Performs other job related duties and assignments as requested
Qualification
Required
Minimum of one to two years experience in financial management in an acute care hospital
Experience with large hospital information systems required, preferably with Siemens Sorian
Knowledge and expertise in the following areas: hospital and physician billing requirements, CPT/HCPCS coding schemes and hospital and physician reimbursement methodologies
Excellent interpersonal, problem solving, critical thinking and written skills
Demonstrated ability to work effectively with department heads and supervisory staff
Superior Excel Skills using Pivot Tables and other Advanced Functions, proficient use of Microsoft Project, PowerPoint and Visio desired
Ability to work with minimum of supervision
Preferred
Bachelors of Science preferred
Company
Cape Cod Healthcare
Cape Cod Healthcare offers a comprehensive array of medical services delivered by top-notch teams of healthcare providers.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Lauf
President and CEO
Richard Silveria
Chief Financial Officer
Recent News
2025-09-10
Company data provided by crunchbase