Fairview Health Services · 8 hours ago
Rev Cycle Complex Claims/Payor Analyst
St Paul, MN
Full-time
Onsite
Mid Level
3+ years expFairview Health Services is a healthcare organization seeking a Payor Analyst to identify, analyze, and resolve payer-related claims issues. This role involves coordinating claims issues through data research, trend analysis, and root cause identification to support timely reimbursement and improve departmental efficiency.
AssociationHealth CareHospitalMedical
Responsibilities
Claims Payer Issue Coordination & Analysis
Perform detailed account reviews and root cause analysis of payer-specific trends and denials
Prepare mitigation strategies and documentation for leadership and payer submission
Aggregate and analyze data to identify systemic issues and support payer resolution efforts utilizing Excel, Epic, PowerBI and denial reporting data
Documentation & Reporting
Collaborate with Revenue Cycle leadership to document, quantify, and consolidate issues for payer submission
Ensure all documentation is complete, accurate, and aligned with payer requirements
Facilitate monthly payer meetings, including agenda preparation, attendance tracking, and capturing and distribution of meeting notes
Subject Matter Expertise
Maintain comprehensive knowledge of payer requirements, reimbursement policies, and claims resolution processes
Stay current with Payer bulletins to apply payer policies to denied claims for timely and appropriate payment processing
Support both macro and micro-level issue resolution, including gaps and delays in payment
Communicate effectively across departments with supporting documentation for all payer-related issues
Leadership Support & Training
Assist leadership in delivering closed-loop communication, feedback, and training to improve departmental efficiency
Promote best practices in claims resolution and payer engagement
Quality & Productivity Monitoring
Conduct staff productivity and quality checks in accordance with departmental policies and business unit standards
Review complex technical and professional billing and collections processes to ensure accuracy and compliance
Organization Expectations, as applicable:
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
Communicates in a respective manner
Ensures a safe, secure environment
Fulfills all organizational requirements
Completes all required learning relevant to the role
Complies with and maintains knowledge of all relevant laws, regulations, policies, procedures and standards
Qualification
Required
3 years experience in a medical billing office with billing or collections experience
MS Office experience
Insurance Follow-up Experience
Coordination of Benefits Experience
Preferred
B.S./B.A
5 years healthcare experience related to billing, coding, reimbursement, and knowledge of payment methodologies of commercial and government payors
Epic Experience
Experience with medical terminology, CPT and ICD-10 coding knowledge
Knowledge of FV account review experience
Knowledge of FV system applications
Benefits
Medical
Dental
Vision plans
Life insurance
Short-term and long-term disability insurance
PTO and Sick and Safe Time
Tuition reimbursement
Retirement
Early access to earned wages
Company
Fairview Health Services
Fairview Health Services is a nonprofit healthcare organization that provides various medical and wellness services.
10001+ employees
H1B Sponsorship
Fairview Health Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (5)
2024 (5)
2023 (3)
2022 (9)
2021 (7)
2020 (5)
Funding
Current Stage
Late StageTotal Funding
unknown2022-11-15Acquired
Leadership Team
James Hereford
President and CEO
Joe Gaylord
Executive Vice President & Chief Financial Officer
Recent News
2025-12-17
Twin Cities Business
2025-12-09
2025-11-23
Company data provided by crunchbase