Payment Analyst, Corporate Office

Location: 100 Abington Executive Park, Clarks Summit, PA, 18411, United States Job Category: Payment Analyst, Patient Accounting, Clerical Employee Type: Full Time Required Degree: 2 Year Degree Manage Others: Yes GENERAL SUMMARY: Under the direction of the Assistant Director of Patient Accounts, the Payment Analyst is responsible for verifying all payments received by the Patient Accounts Department are proper as per Allied Services contracts and federal and state regulations. The Payment Analyst is responsible for knowing and understanding federal and state regulations as they relate to healthcare billing and reimbursement. This role involves building and maintaining all contracts and federal and state regulations within various software applications. The Payment Analyst identifies all underpayments and overpayments and assigns them to the appropriate staff for follow-up. Additionally, the analyst maintains accurate accounts receivable balances from the time of the first bill through payment in full and develops and implements education and training for the Patient Accounts Department to ensure compliance with federal, state, and contract terms. EDUCATION: Associates degree in business or information technology required; Bachelor’s degree in business or information technology preferred. WORK EXPERIENCE: Minimum of three years in a Healthcare Facility setting required; five years preferred. CHARACTERISTIC DUTIES & RESPONSIBILITIES OF JOB: Reviews all payment queues in HPF (Horizon Patient Folder) to verify that each payment received is appropriate and correct. Each payment is researched to confirm it was posted to the correct patient’s account, against the correct services, and is in accordance with contract terms and/or federal and/or state regulations. Incorrect payments are identified and researched, and decisions are made on the most appropriate action for follow-up, which is then assigned to a Patient Account Representative. Maintains patient account balances by posting contractual allowances, adjustments, small balance write-offs, A/R payer transfers, and payment transfers as appropriate. Also reclassifies and rebills patient accounts to correct payers for accurate contract term application. Responsible for reviewing and understanding all new contracts, addendums to contracts, and rate changes, as well as new and updated federal and state regulations and reimbursement. Builds and maintains all contract terms and regulatory updates in McKesson Pathways Contract Manager (PCON), McKesson Series, and PointClickCare (PCC). Tests each build and verifies adjustments and expected payments are correct. Tests interfaces between systems for seamless transition and reviews and resolves all error and variance reports. Keeps management aware of trends and issues with respect to incorrect payments and advises management where education or training is needed when incorrect payments are related to billing. Assists third-party auditors for fiscal year-end audits and in the preparation of statistical reports. Participates in formal training and educational seminars as required.

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