What are the responsibilities and job description for the Analyst, Reimbursement Integrity position at NAPA Management Services Corporation?
Sunrise,FL - USA Position Requirements RESPONSIBILITIES Contracted Payer Variance Bachelor’s Degree in Finance, Accounting, or related field. Analyze and review accounts with payment discrepancies, including underpayments and overpayments, using contractually established allowable amounts. Investigate root causes of variances, working with payers, provider representatives, and internal teams to recover underpayments or process refunds for overpayments. Compare and validate reimbursement amounts using payer contracts, system-calculated allowables, and actual payments received from insurance payers. Work closely with billing and collections teams to escalate claim disputes, submit appeals, and follow up on unresolved payment variances. Reporting and Data Analysis Utilize advanced Excel functions (VLOOKUP, INDEX/MATCH, PivotTables, Power Query, Macros, VBA) to efficiently process large datasets and identify trends. Develop and automate reports using Excel, SQL, or other data analysis tools to track variance trends, systemic payer issues, and revenue impact. Provide data-driven insights to leadership regarding financial performance, payer compliance, and areas for process improvement. Payer Contract Compliance and Collaboration Ensure accurate contract load and pricing within the billing system in collaboration with the contracting team. Identify trends and patterns in payer reimbursements that may indicate systemic issues, policy changes, or contract discrepancies. Work closely with contracting and revenue cycle leadership to address reimbursement challenges and optimize contract terms. Process Improvement Stay updated on industry regulations, payer policies, and reimbursement methodologies (e.g., Medicare, Medicaid, and commercial payers). Continuously seek process improvements, leveraging automation and Excel modeling to enhance efficiency and accuracy in revenue integrity workflows. REQUIRED QUALIFICATIONS 2 years of experience in revenue cycle, healthcare reimbursement, claims auditing, or contract analysis. Expert-level proficiency in Microsoft Excel, including advanced formulas, PivotTables, Power Query, Macros, and VBA. Strong analytical and problem-solving skills with the ability to work with large datasets efficiently. Knowledge of payer contracts, reimbursement methodologies, and allowable calculations in a healthcare setting. Excellent communication and collaboration skills to work effectively with internal teams and payers. Ability to work independently while managing multiple priorities in a fast-paced environment. PREFERRED QUALIFICATIONS Experience working with managed care contracts and government payers. Familiarity with contract modeling tools, SQL, Power BI, or other data visualization tools. The Revenue Integrity Analyst plays a critical role in ensuring accurate reimbursement and payer contract compliance within the revenue cycle. This position is responsible for identifying, analyzing, and resolving payment discrepancies by comparing actual payments against contractually agreed allowable amounts. This position includes analyzing underpayments and overpayments, validating payer reimbursements against contracts, collaborating with internal teams and payers to resolve variances, and providing data-driven insights to improve revenue cycle performance. The Revenue Integrity Analyst works closely with billing, collections, and contracting teams to ensure accuracy in payment processing and compliance with industry regulations. EEO Statement North American Partners in Anesthesia is an equal opportunity employer. North American Partners in Anesthesia (NAPA) has evolved through more than 30 years to become a leader in anesthesia and perioperative services. Single specialty and clinician led, we remain committed to our mission of delivering exceptional patient experiences, every day. At NAPA, we cultivate leaders, promote work-life balance, and celebrate diversity. We know your success promotes our success, and we give you the tools and programs to achieve your goals. With flexibility, a collegial and collaborative environment, a wide range of market-leading benefits, and career opportunities from coast-to-coast, your future is waiting at NAPA.
