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RCM Payer Profile Analyst - Synapse Health

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Job Title
RCM Payer Profile Analyst
Job Location
Remote
Job Description

Synapse Health | Who We Are

With the collective efforts of our epic team members, we’re trailblazing a new path in the DME industry. Synapse Health was founded in 2016 with a goal to fix the fractured DME ecosystem and completely transform the industry. Built on decades of industry and leadership experience, we’ve launched tech-based solutions that eliminate age-old DME headaches, resulting in a seamless experience for all. We are proud to offer work that matters, on a mission that matters.  

Intrigued? Learn more at SynapseHealth.com and on Synapse Health’s LinkedIn.

What We Need

We are looking for a RCM Payer Profile Analyst that will report directly to the Director of Revenue Cycle Management and indirectly to the Operations Leadership Team. This team member is responsible for maintaining and updating the Chargemaster (payor tables) in the billing system and will ensure accurate, up-to-date and compliant coding and pricing of DME equipment and supplies. Working cross-functionally at all levels of the organization, this person collaborates with various departments including finance, revenue cycle, compliance and operations to optimize revenue capture and maximize financial performance. This role requires a strong understanding of healthcare reimbursement methodologies, fee schedules, payer rules, system configuration, compliance standards and a commitment to maintaining the highest level of data integrity. 

What You Will Do

  • Regularly update the Chargemaster and billing system with new codes, price groups, fees and price options, prior authorization rules, re-supply rules, rental options and intervals, combined/split logic, etc. 
  • Monitor and adhere to all regulations, guidelines, payer rules and requirements related to charge capture, billing, and coding.
  • Manage special projects related to the payor tables and fee schedules such as implementing new business and revenue opportunities.
  • Research and monitor reimbursement problem areas, such as payer denials and work with leadership to resolve problems and optimize reimbursement and/or profitability.
  • Coordinate and manage a change control process, ensuring the appropriate approvals are obtained prior to making updates to the payor tables.
  • Work cross-functionally with all levels throughout the organization to maintain and update the payor tables.
  • Perform periodic comprehensive reviews and audits to ensure charges are being billed appropriately and captured accurately.
  • Collaborate with compliance and other stakeholders to ensure the organization's adherence to healthcare regulations and mitigate compliance risks.
  • Perform additional job duties as assigned.

What You Have

At Synapse Health we’ve intentionally built a culture of kindness, collaboration and creativity, and we consider those qualities to be table stakes for any new team member. Additional requirements include: 

  • Bachelor’s degree in healthcare administration, business administration, finance, or related field preferred; although, a combination of relevant education and experience may be considered.
  • Minimum of 3 years' experience maintaining a Chargemaster with a professional and/or hospital healthcare organization.
  • DME revenue cycle experience strongly preferred.
  • Niko Health or Brightree experience strongly preferred.
  • Coding certification strongly preferred.
  • Expert understanding of healthcare reimbursement/collections, medical billing, ICD10 coding and state & federal regulations.
  • Ability to research, review and interpret Medicare/Medicaid, Federal, State and Local billing regulations. Able to communicate regulations to the necessary departments.
  • Advanced skills with MS Office applications including Outlook, Work, Excel and PowerPoint.
  • Demonstrate high attention to detail and a high degree of accuracy.
  • Demonstrate organizational skills.
  • Demonstrate effective verbal and written communication skills.
  • Demonstrate analytical skills when problem-solving.

What Sets You Apart

  • Accountability: Demonstrates an understanding of the link between one's own job responsibilities and overall organizational goals and needs. 
  • Analytical Thinking: Demonstrates the ability to deconstruct information into smaller categories in order to draw conclusions. 
  • Decision Making: Manages to make the right decision in complex situations. 
  • Management and Leadership: Demonstrates the ability to influence and guide members of an organization. 
  • Result Oriented: Demonstrates knowledge in setting and achieving challenging goals. 

What Sets Us Apart 

It’s no secret that most of us work to provide for ourselves and those we love, but just because we have to work, doesn’t mean we can’t enjoy it. In fact, at Synapse Health, we insist on it! We want our team members to thrive personally and professionally, which is why our benefits include: 

  • Professional growth opportunities with compelling career paths
  • Healthy work-life balance culture with Flexible time off (FTO)
  • Medical, dental and vision insurance for full-time team members
  • 401K savings plan with employer contribution match

Synapse Health is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

 

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Synapse Health Headquarters Location

Evanston, IL

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Synapse Health Company Size

Between 20 - 100 employees

Synapse Health Founded Year

2021

Synapse Health Total Amount Raised

$40,000,000

Synapse Health Funding Rounds

View funding details
  • Series Unknown

    $25,000,000 USD

  • Series Unknown

    $15,000,000 USD