Job Description

THIS POSITION IS REMOTE.  CANDIDATES MUST RESIDE IN VIRGINIA. 

APPLY AT WWW.ORTHOVIRGINIA.COM/CAREERS

OrthoVirginia, Virginia's largest provider of expert orthopedic and therapy care, is currently seeking a FULL-TIME, EXPERIENCED CONTRACT COMPLIANCE ANALYST to join the OrthoVirginia team! Along with a collaborative, team-oriented work environment, our outstanding employment package includes: competitive salaries, excellent medical, dental, and vision benefits, paid time off (PTO), a generous 401k incentive plan, short-term and long-term disability insurance, life insurance, and a company-wide wellness program.

Position Summary

The Contract Compliance Analyst is primarily responsible for the daily review and management of insurance payment variances identified using a contract compliance tool.

Primary Functions & Accountabilities

• Act as a contact within Revenue Cycle Management Operations for payer information, payer communication and issue identification
• Maintain all Fee Schedules and Contracts within the contract compliance tool
• Generate reports to identify and report payment variances from insurance carriers
• Report payment processing discrepancies to manager
• Initiate practice management support tickets when necessary and approved by management
• Facilitate resolution of payment discrepancies with payer provider representatives
• Appeal bulk variance types with payer. Follow-up on appeals until resolved
• Perform other duties as requested by the RCM Director or Manager
• Knowledge of ICD-10, CPT and HCPCS codes
• Knowledge of healthcare insurance billing and collections
• Knowledge of insurance plan required billing procedures
• Knowledge of insurance contracts and fee schedules
• Excellent oral and written communication skills
• Excellent organizational and time management skills with ability to multitask
• Proficiency with medical terminology
• Strong detailed analytical skills
• Detail oriented and proactive with resolving data anomalies
• Ability to maintain confidentiality of patient and employee information
• Working knowledge of Microsoft Excel, and practice management systems

Knowledge, Skills & Abilities

• Knowledge of ICD-10, CPT and HCPCS codes
• Knowledge of healthcare insurance billing and collections
• Knowledge of insurance plan required billing procedures
• Knowledge of insurance contracts and fee schedules
• Excellent oral and written communication skills
• Excellent organizational and time management skills with ability to multitask
• Proficiency with medical terminology
• Strong detailed analytical skills
• Detail oriented and proactive with resolving data anomalies
• Ability to maintain confidentiality of patient and employee information
• Working knowledge of Microsoft Excel, and practice management systems

Position Requirements

• High school diploma or equivalent
• 3 years of medical billing/medical coding experience required
• Progressive responsibility for coding preferred
• Physical health sufficient to meet the ergonomic standards and demands of the position

Company Description

OrthoVirginia is the state’s largest provider of expert orthopedic and therapy care which serves the needs of its patients through a team of highly trained specialists who are committed to the independent practice of medicine. Located in Central Virginia, Northern Virginia, Virginia Beach and Western Virginia (Lynchburg, Bluefield, Wytheville, Christiansburg and Blacksburg). OrthoVirginia has over 100 physicians, 34 office locations to include MRI facilities, office operatories, physical and hand therapy clinics and sports medicine clinics. Its mission is to improve the musculoskeletal health and well-being of those who live in the communities that it serves. OrthoVirginia’s statewide network of physicians and healthcare providers strives to deliver high quality, cost effective orthopaedic care to its patients.