Contract Payer Analyst

Were with you for lifes journey. At Denver Health purpose isnt just something we believe inits something we live every day for lifes journey.

Our Values

Respect Belonging Accountability Transparency

Department

• 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%)

• Bachelors Degree Business Administration Health Care Administration or related health care field. Required

• 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

• 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.

Shift

Work Type

Salary

Benefits

At Denver Health we take care of the people who take care of our community. Our benefits are built to support your life your family and your future with generous paid time off fully paid parental leave exceptional retirement contributions comprehensive health coverage and nationally recognized well-being programs. We invest in your growth through tuition assistance career advancement pathways and professional development while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health youre joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

• Paid time off starting at 28 days per year inclusive of vacation personal/sick and 7 Holidays

• 100% paid parental leave up to 6 weeks

• Immediate eligibility for retirement plans with employer contribution up to 9.5%

• Generous medical dental vision plans in addition to employer paid disability and life insurance.

• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center

• Free RTD EcoPass (public transportation)

• Childcare discount programs & exclusive perks on large brands travel and more

• Tuition reimbursement & assistance

• Education coaching and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways

• 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 employer

About Denver Health

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 Denvers 911 emergency medical response system 10 family health centers 19 school-based health centers Rocky Mountain Poison & Drug Safety the Public Health Institute at Denver Health Denver Health Medical Plan and Denver Health Foundation.

As Colorados primary and essential safety-net health care system Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each 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. All job applicants for safety-sensitive positions must pass a pre-employment drug test once a conditional offer of employment has been made. Applicants will be considered until the position is filled.