PFS Contract Variance Analyst

Role Description

We are currently seeking a PFS Contract Variance Analyst to join our Denials Analysis team. This full-time role will work remotely (Days, M-F).

The Contract Variance Analyst provides foundational support in managing appeals related to payer contract variances and fatal denials. This role is responsible for:

• Assisting with appeal documentation, tracking, and submission processes
• Collaborating with internal teams to gather necessary information
• Maintaining data accuracy within tracking systems
• Preparing routine reports
• Participating in training and process improvement initiatives

This position offers an opportunity to build expertise in revenue cycle operations and payer relations while ensuring compliance with organizational and regulatory standards.

Qualifications

• Bachelor’s degree in Business, Finance, Health Care Administration, or related field
• 1 year of experience in healthcare contract variance analysis, including an in-depth knowledge of healthcare claims processing
• -OR- An approved equivalent combination of education and experience

• Excellent problem solving skills
• Knowledge of EPIC claims processing systems and electronic health records
• Must have skills in data analysis and associated tools
• Proficiency with Microsoft Office
• Proficient with database reports (Clarity, EPIC workbench, etc)

Requirements

• Supports the Contract Variance Appeal process by assisting with intake, documentation, and tracking of appeals submitted to third-party payers
• Prepares and submits appeals to third-party payers under guidance, monitors status updates, and follows up to ensure timely resolution
• Conducts basic research to support appeal documentation and stays informed on payer updates and policy changes
• Collaborates with internal teams to gather necessary information for appeal resolution
• Maintains and updates tracking systems, ensuring accurate data entry and assisting with report generation
• Compiles and organizes data to help identify trends in contract variances and denials
• Prepares standard reports and summaries for review by senior analysts and leadership
• Escalates complex issues to senior team members and participates in team discussions to support problem-solving
• Participates in team-based quality and process improvement initiatives to enhance workflows and outcomes
• Ensures compliance with HIPAA, organizational policies, and applicable regulations in all work activities
• Demonstrates professionalism and attention to detail in communications and documentation
• Assists with system testing and documentation updates related to Contract Variance workflows
• Engages in training and development opportunities to build knowledge and skills relevant to the role
• Supports the appeals process by helping assess and document Contract Variances and Fatal Denials under supervision
• Updates performance dashboards, verifying data accuracy and completeness
• Prepares meeting materials and gathers documentation for leadership review
• Maintains a positive, team-oriented approach, contributing to a collaborative work environment
• Performs other duties as assigned to support the Contract Variance team and department goals

Company Description