Fee Schedule Analyst

Job Type: Temp to Perm
Location: Maitland, FL 32751
Work Schedule: Hybrid - 3 days in office, 2 days remote
Hours: Start time (7am- 9am) & End time (3:30pm - 5:30pm) (30 min lunch)
Compensation: $27/hr - $28/hr
Benefits: Health, Dental, Vision while on temp; Full Benefits on Perm (Health, Dental, Vision, PTO, Holidays, 401K)

Sanford Rose is seeking a Fee Schedule Analyst for a leading healthcare services organization operating 90 treatment centers across 20 states. This position supports the Managed Care team by ensuring fee schedules, CPT codes, billing codes, reimbursement terms, and payer agreements are accurate and compliant. The ideal candidate enjoys investigative work, has exceptional attention to detail, and thrives on researching and resolving discrepancies.

Responsibilities:

• Review and audit all new and legacy payer fee schedules across a multi-state healthcare organization.
• Compare contracted reimbursement terms against actual fee schedules to ensure coding and reimbursement accuracy.
• Validate CPT codes, revenue codes, billing frequencies, and compliance requirements against payer contracts and provider manuals.
• Research and reconcile discrepancies between contract language, fee schedules, and system configuration.
• Extract reimbursement rates, fee schedules, coding requirements, and applicable language from payer contracts and provider manuals.
• Ensure billing codes are applied correctly according to payer-specific guidelines and allowable billing frequencies.
• Perform detailed reconciliations and document findings, recommendations, and required corrections.
• Collaborate with the Managed Care team to resolve coding and reimbursement issues while maintaining strict accuracy standards.
• Prioritize multiple audits simultaneously while meeting established deadlines.
• Continuously research payer requirements and contract updates to maintain compliance across all facilities.
• Work primarily with a focused set of approximately 28 CPT codes, developing deep subject matter expertise while applying consistent audit processes across multiple payer contracts.

Qualifications:

• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), or equivalent coding certification Highly preferred
• 3 years of experience within Managed Care, Substance Use Disorder (SUD), or behavioral healthcare required.
• Strong analysis/understanding of medical coding, CPT codes, fee schedules, reimbursement methodologies, and payer contracts.
• Experience locating, interpreting, and extracting reimbursement rates and coding requirements from provider manuals and managed care contracts.
• Demonstrated experience performing coding, reimbursement, or contract audits with exceptional attention to detail.
• Strong analytical and investigative skills with the ability to independently research complex reimbursement questions.
• Excellent organizational and time management skills with the ability to manage multiple priorities and meet strict deadlines.
• High level of accuracy with a commitment to completing work correctly the first time.

At Sanford Rose Associates - JFSPartners, we specialize in Finance & Accounting, Legal, and Information Technology recruitment, dedicated to helping professionals like you discover the perfect career opportunities. With a track record of assisting thousands of professionals nationwide, we are prepared to leverage our expertise on your behalf. Partnering with us means gaining access to serious candidates, minimizing hiring errors, and helping you hire top-tier talent, all while navigating the hiring process with confidence. We understand the significance of finding the ideal role and aligning with an organization that shares your values.

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