Payer Integrity Analyst III

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

The Payer Integrity Analyst III - Remote is responsible for national payers’ accounts receivables ($5m+) as assigned to identify, manage and resolve systemic trends causing collection delays for the providers; such as, Hanger Clinics and independent providers. 

• Primarily work with the Health Plan Director, National Account Manager within Hanger and various levels at the payer
• Proactively address systemic trends and reporting results and making recommendations for improvements
• Serve as a subject matter expert and identify, analyze and resolve claims issues, for specific payers, to reduce claims denials and to promote faster (cleaner) claims processing
• Communicate root cause/resolution to appropriate parties, including payers
• Analyze claims data on a proactive basis to identify potential areas for improvement in claims processing, making recommendations for improved processes
• Analyze and trend payer's outstanding A/R reports, as assigned, to identify systemic trends requiring either company or payer changes to claims systems or additional provider education.
• Manage projects related to payer engagement with new clinic startups, relocations, closures, subsidiary TIN mergers and acquisitions.
• Lead claims reprocessing projects as required for assigned payers
• Maintain key payer relationships for efficient escalation and problem resolution
• Generate reports using various software programs to support identified systemic payer trends
• Provide trainings / instructions for payers on how to submit appeals, find information on websites. etc

• Bachelor’s degree in related field or equivalent work experience to substitute for the bachelor’s degree.
• Minimum of 5 years of related experience working with third party payers to resolve ongoing issues or related field
• Certification in medical coding preferred

• Excellent interpersonal skills including the ability to communicate effectively with internal and external customer base
• Able to work independently, proactively with little supervision and also as a team player
• Able to prioritize projects and effectively management requirements and dead lines
• Exceptional analytical and problem solving skills with the ability to analyze and interpret simple financial and statistical data
• Strong attention to detail and analytical skills
• Strong knowledge of revenue cycle process, revenue integrity and its impact throughout the revenue cycle
• Ability to maintain the security of confidential information
• Advanced knowledge of policies, standards and methodologies pertaining to charge capture and reconciliation, reporting, documentation and general compliance
• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results.

#LI-Remote

Pay range of $61,800 to $78,000 annual salary + annual bonus: up to 8% of base pay depending on bonus criteria.  This pay range is posted to comply with wage transparency laws.  Hanger salary ranges vary based on skill, ability, knowledge, geographic location and other variables.  

• Competitive Compensation Packages
• 8 Paid National Holidays & 4 additional Floating Holidays
• PTO that includes Vacation and Sick time
• Medical, Dental, and Vision Benefits
• 401k Savings and Retirement Plan
• Paid Parental Bonding Leave for New Parents
• Flexible Work Schedules and Part-time Opportunities
• Generous Employee Referral Bonus Program
• Mentorship Programs- Mentor and Mentee
• Student Loan Repayment Assistance by Location
• Relocation Assistance
• Regional & National traveling CPO/CO/CP opportunities
• Volunteering for Local and National events such as Hanger’s BAKA Bootcamp and EmpowerFest

Hanger, Inc. is committed to providing equal employment opportunity in all aspects of the employer-employee relationship. All conditions and privileges of employment are administered to all employees without discrimination or harassment because of race, religious creed, color, age, sex, sexual orientation, gender identity, national origin, religion, marital status, medical condition, physical or mental disability, military service, pregnancy, childbirth and related medical conditions, special disabled veteran status, or any other classification protected by federal, state, and local laws and ordinances. The company will comply with all applicable state or local fair employment laws that forbid discrimination or harassment on the basis of other protected characteristics. Retaliation against any employee for filing or supporting a complaint of discrimination or harassment is prohibited.

#ERF-HPO