Payment Variance Specialist

Position Details

Department: PCH-MAIN | Physician Revenue Cycle
Category: Patient Financial Services
Location: Phoenix
Employee Type: Regular
Posting #: 486083
Posted On: 11/19/2019

Position Summary

This position is responsible for conducting regular analysis of payments received from contracted payers, making quantitative comparisons to determine if the appropriate reimbursement was received, monitoring contractual allowances, and analyzing and pursuing appeal opportunities with contracted payers and reporting variance/appeals performance.

Position Duties

  1. Reviews and analyzes accounts, reports, and EOBs to identify, track, and appeal over and under-allowed claims.
  2. Batches, compiles, and submits appeals and monitors payments for proper reimbursement. Documents all variance and appeal activity in the appropriate system.
  3. Maintains reports to aid in work flow and appeal opportunities and to track recovery payments.
  4. Establishes and maintains effective communication with payers and leadership to secure accurate and pertinent information to maximize reimbursement.
  5. Uses good interpersonal skills to promote positive and effective interaction with others. Promote quality service to ensure the flow of information to appropriate staff, provider representatives and leadership.
  6. Verifies applicable contract rates by reviewing payer contracts, EOBs, and verifying member information for all healthcare plans.
  7. Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values

Mission

To advance hope, healing and the best healthcare for children and their families

Vision

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

  • Offering the most comprehensive care across ages, communities and specialties
  • Investing in innovative research, including emerging treatments, tools and technologies
  • Advancing education and training to shape the next generation of clinical leaders
  • Advocating for the health and well-being of children and families
Values
  • We place children and families at the center of all we do
  • We deliver exceptional care, every day and in every way
  • We collaborate with colleagues, partners and communities to amplify our impact
  • We set the standards of pediatric healthcare today, and innovate for the future
  • We are accountable for making the highest quality care accessible and affordable
The position has been closed or filled.

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