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! This is a remote position based in Virginia. Candidate MUST reside in Virginia. 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