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Payer Analysis Director in Houston at Parallon

Date Posted: 4/16/2019

Job Snapshot

  • Employee Type:
  • Location:
  • Job Type:
  • Experience:
    At least 5 year(s)
  • Date Posted:

Job Description

Job Summary – The Payer Analysis Director is responsible for overseeing the government logging and the discrepancy analysis functions. The logging and discrepancy function includes verifying the accuracy of the calculated contractual adjustments and analyzing payment discrepancies to determine root causes. This individual is responsible for consistent application of all standard A/R and Accounting processes, and for accurate and timely discount and allowance calculations, analyses and reconciliations. As part of this role, this individual must demonstrate strong commitment to stakeholder relationships by taking ownership of issues and facilitating effective outcomes in a timely manner.
Supervisor – SSC CFO
Supervises – Logging and Discrepancy Management and Staff
Duties (included but not limited to): 
  • Oversee the logging and discrepancy analysis functions. 
  • Ensure consistent application of A/R adjustment and standard accrual tools to calculate appropriate discounts and allowances by payer class and insurance plan. 
  • Oversee management of logs, including verification of log accuracy, daily reporting and analysis and resolution of discrepancies. 
  • Understand and communicate contract specific issues related to discount and allowance calculations for a variety of payers such as Medicare, Medicaid, HMO’s, PPO’s, IPA’s, employers, etc. 
  • Oversee management of personnel, providing recommendations for hiring, promotion, salary adjustment and personnel action where appropriate. 
  • Establish controls and review mechanisms for SSC policies and procedures.
  • Monitor trends and communicate significant shifts in market or operating conditions to SSC and facility leadership. 
  • Identify and implement process improvements to lower cost to collect and improve services to customers. 
  • Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”. 
  • Other duties as assigned.

Job Requirements

  • Technical Expertise – Some understanding of healthcare including knowledge of healthcare terms and accounts receivable processes   Strategic Analysis - Analytical review skills and ability to make decisions based on analysis. 
  • Leadership - Guides individuals and groups toward desired outcomes, setting high performance standards and delivering leading quality services.
  • Tactical Execution - Oversees the development, deployment and direction of complex programs and processes. 
  • Financial Management - Applies tools and processes to successfully manage to budget.  
  • Project Management - Assesses work activities and allocates resources appropriately.  
  • Organization - Proactively prioritizes needs and effectively manages resources. 
  • Communication - Communicates clearly and concisely, verbally and in writing.  This includes utilizing proper punctuation, correct spelling and the ability to transcribe accurately. The ability to communicate with staff, Parallon Management, Division and Group Executives.  
  • Customer Orientation - Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations. 
  • Interpersonal skills - able to work effectively with other employees, patients and external parties. 
  • PC Skills - Demonstrates proficiency in Microsoft Office applications and others as required. 
  • Policies & Procedures - Demonstrates knowledge and understanding of organizational policies, procedures and systems. 
  • Basic Skills – Demonstrates ability to organize, perform and track multiple tasks accurately in short timeframes.  Demonstrates ability to work both independently and collaboratively as a team player.  
  • Bachelor’s Degree in Business or related field required. 
  • Minimum 5 years healthcare management experience with three of these years in the related area for the position.  Relevant education may substitute experience requirement with SSC Executive approval.