Revenue Cycle Payer Contract Analyst
Job Description
At SCA Health, we believe health care is about people – the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000+ professionals working together, learning from each other and living out the mission, vision and values that define our organization.
As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.
What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values:
- Clinical quality
- Integrity
- Service excellence
- Teamwork
- Accountability
- Continuous improvement
- Inclusion
Our values aren’t empty words – they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.
At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.
Your ideas should inspire change. If you join our team, they will.
Responsibilities
** The work schedule will be Monday - Friday from 8am - 5pm your local time **
Position Purpose: Provide support to RCO Site Engagement, CBO teams, and facilities by maintaining & managing vital RCO systems & processes
- Organize, review, and load payer contracts negotiated by SCA Health or health system partners to the Payer Contracts Database (PCD) and patient accounting systems – primarily HST Practice Management.
- Build and load payer fee schedules to the PCD, as needed and patient accounting systems – primarily HST Practice Management.
- Obtain and load standard payer (state Medicaid, state workers compensation, federal workers compensation) fee schedules to the PCD.
- Review and respond to payer contract questions submitted via the Teammate Service Center.
- Review and load self-pay fee schedules to PCD as needed.
Secondary position responsibilities:
- Assist with receiving and logging health system contract submissions into SmartSheet.
- Assist with quarterly Medicare fee schedule update in the PCD and HST Practice Management.
- Assist with payer mapping in PCD and HST Practice Management.
- Assist with organizing, reviewing, and building anesthesia fee schedules for loading to PCD and HST Practice Management.
Qualifications
Requirements for our roles:
- High School Diploma or GED completed
- Must have at least 5 years of Healthcare work experience
- Must have at least 3 years of payer contract knowledge
- Must be proficient with Microsoft Outlook, Excel, Word, Teams and SharePoint
Requirements for our roles:
- High School Diploma or GED completed
- Must have at least 5 years of Healthcare work experience
- Must have at least 3 years of payer contract knowledge
- Must be proficient with Microsoft Outlook, Excel, Word, Teams and SharePoint
** The work schedule will be Monday - Friday from 8am - 5pm your local time **
Position Purpose: Provide support to RCO Site Engagement, CBO teams, and facilities by maintaining & managing vital RCO systems & processes
- Organize, review, and load payer contracts negotiated by SCA Health or health system partners to the Payer Contracts Database (PCD) and patient accounting systems – primarily HST Practice Management.
- Build and load payer fee schedules to the PCD, as needed and patient accounting systems – primarily HST Practice Management.
- Obtain and load standard payer (state Medicaid, state workers compensation, federal workers compensation) fee schedules to the PCD.
- Review and respond to payer contract questions submitted via the Teammate Service Center.
- Review and load self-pay fee schedules to PCD as needed.
Secondary position responsibilities:
- Assist with receiving and logging health system contract submissions into SmartSheet.
- Assist with quarterly Medicare fee schedule update in the PCD and HST Practice Management.
- Assist with payer mapping in PCD and HST Practice Management.
- Assist with organizing, reviewing, and building anesthesia fee schedules for loading to PCD and HST Practice Management.