Job Description

OF POSITION:

• The Revenue Integrity Contract Analyst collaborates with Epic Information Systems and Health Information Management to extract and analyze account-level reimbursement data, ensuring ongoing accuracy and compliance across all transactions.

SUPERVISION: Reports directly to the Director of Revenue Cycle with a dotted line to the Epic Business Systems Team Lead.

RESPONSIBILITIES AND DUTIES:

• Maintains and updates contract fee schedules within Epic, ensuring alignment with payer agreements and organizational standards.
• Monitors payer payment patterns and net down trends to identify discrepancies and opportunities for revenue optimization.
• Performs thorough contract evaluations and collaborates with Epic Analysts to resolve system­related issues impacting reimbursement.
• Proficient in using payment review systems, hospital information systems, and various coding methodologies (e.g., ICD, CPT, HCPCS).
• Demonstrates strong ability to interpret medical records, hospital bills, and the charge master for accurate payment analysis.
• Understands the operational functions of all ancillary departments to support comprehensive contract and payment reviews.
• Effectively negotiates with insurance carrier representatives and customers to resolve payment disputes and secure appropriate reimbursement.
• Analyzes managed care contracts and reconciles them against actual payments received to identify underpayments or inconsistencies.
• Utilizes internal automation tools and software applications to streamline audit and reconciliation processes.
• Successfully identifies and collects underpayments from insurance carriers, contributing to improved revenue recovery.
• Accurately documents audit findings and payment discrepancies in the hospital information system to ensure transparency and traceability.
• Provides monthly insights and recommendations to leadership aimed at preventing future cash losses and improving financial performance.
• Demonstrates the ability to manage multiple projects simultaneously, applying innovation, creativity, and strategic vision to achieve goals.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• Bachelor Degree or 2-4 year degree (or equivalent working experience) in healthcare related field preferred.
• Experience with PCs, word processing, spreadsheet, graphics, and database software applications are desired. Previous auditing experience preferred.
• Ability to read, write and speak intelligible English; Strong quantitative, analytical, and organizational skills; Ability to communicate orally and in written form. Must be detail oriented.
• Requires emotional stability and maturity; Must be adaptable to change, be decisive, and demonstrate foresight; Exhibits organizational and leadership ability. Must be team oriented with strong interpersonal skills.

Physical Demands/Work Environment

• Work requires light duty lifting.
• Must be able to remain in a stationary position 50% of the time.
• Constantly operates a computer and other office machinery such as calculator, copy machine, and computer printer.
• Must be able to exchange accurate information with patient, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

“Experience Memorial” is more than a slogan, it’s the care we provide our patients and it’s the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.

Working at Lake Charles Memorial Health System | Great Place To Work®