Revenue Cycle Payor Analyst

RESPONSIBILITIES:
A client with Kforce is seeking a Revenue Cycle Payor Analyst to join their team. This is a hybrid opportunity with 2-3 days a week onsite on Fort Meyers, FL. Clients employees are the foundation of their success. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role.

Summary:
The Revenue Cycle Payor Analyst is responsible for ensuring the financial health of the organization by managing and optimizing the revenue cycle process. This position is responsible for handling payor-related activities, including claims submission, follow-up, denial management, and resolution of payment discrepancies. The Specialist will have a strong understanding of payor policies, billing practices, and revenue cycle workflows, with the ability to work independently and collaboratively to meet departmental goals.

Responsibilities:
* Prepare, review, and submit accurate claims to payors on time
* Monitor claims for errors, rejections, and compliance with payor requirements
* Analyze and resolve claim denials by identifying root causes and implementing corrective actions
* Prepare and submit appeals for denied claims, ensuring proper documentation and adherence to payor guidelines
* Review and reconcile payments received from payors against expected reimbursement
* Investigate and resolve payment discrepancies, including underpayments and overpayments
* Serve as the primary point of contact for payors to address claim-related inquiries and issues
* Maintain up-to-date knowledge of payor policies, procedures, and contract terms
* Ensure compliance with federal, state, and local regulations, as well as organizational policies
* Maintain accurate and detailed records of all claim activities, communications, and resolutions

REQUIREMENTS:
* Bachelor's degree in Healthcare Administration, Business, or a related field is required
* 3+ years of experience in revenue cycle management, medical billing, or a related field
* Experience with payor-specific policies, claims processing, and denial management is required
* Strong knowledge of healthcare billing practices, CPT/ICD coding, and payor regulations
* Proficiency in using revenue cycle management software and electronic health record (EHR) systems
* Excellent analytical, problem-solving, and organizational skills

The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.

We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.

Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce's sole discretion unless and until paid and may be modified in its discretion consistent with the law.

This job is not eligible for bonuses, incentives or commissions.

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

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