Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding career at Grady!

SUMMARY
The Payment Variance Analyst is responsible for conducting regular analysis of payments received from contracted payers and making quantitative comparisons to determine if the hospital received the appropriate reimbursement.

QUALIFICATIONS

• Baccalaureate Degree in Finance, Accounting, Healthcare Administration, Business or related area; or equivalent education, training and/or experience required
• Healthcare Financial Management Association (HFMA) Patient Accounts and Hospital Accounting Certification; CPAR certification, Advanced CPAR or CPAM preferred
• Significant (3+ years) experience with the following:
  • a. Hands-on experience in hospital business office account follow-up, including zero payment, denials resolution and underpayment/variance resolution
  • b. Experience with performance trending reports related to denials and payment variance
  • c. Hands-on knowledge of denial management functions (electronic and manual)
  • d. Hands-on knowledge of payer contracts and underpayment variance functions (electronic and manual)
  • e. Hands-on knowledge of Medicare, Medicaid, Medicaid CMO, Commercial, Managed Care billing regulations and experience with UB-04 and HCFA 1500 claims forms billing and follow-up activities
  • f. Hands-on knowledge of CCI, OCE edits - Working knowledge of Medicare secondary payer, as well as medical necessity requirements
  • g. Hands-on knowledge of CPT, ICD-9, HCPCS, and Revenue codes, as well as hospital billing terminology
  • h. Demonstrated service and success in teamwork and collaboration
• Business knowledge and results oriented experience within Patient Financial Services
• Experience within a large academic facility is desirable
• Siemens INVISION and/or Epic experience preferred
• Experience in process re-engineering, project planning and management
• Mastery of Microsoft Office Suite of applications, including but not limited to Access, Excel, Word, PowerPoint and Visio
• Excellent communication, time management, organizational skills
• Demonstrated ability to be flexible, work collaboratively among internal and external departments, as applicable to identify and help resolve enterprise-wide challenges
• Demonstrated ability to effectively investigate, analyze and problem solve
• Demonstrated ability to accurately type 30 words per minute
• Successfully pass pre-employment competency testing with 80% proficiency

Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.