Benefits
- Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.
- Future Security: 401(k) with matching
- Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.
- Educational Tuition Assistance
- Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.
Job Summary
The Payment Compliance & Contract Management (PCCM) Specialist supports reimbursement accuracy by reviewing payment outcomes, identifying discrepancies, and resolving variances between expected and actual reimbursement. This role evaluates contract terms, payer behavior, and claim activity to address underpayments, denials, and revenue opportunities. The PCCM Specialist partners with internal teams and external payers to resolve issues and support efficient, compliant revenue cycle operations.
Essential Functions
- Reviews reimbursement outcomes to identify underpayments, overpayments, denials, and revenue leakage.
- Investigates payment discrepancies and resolves issues through account follow-up, appeals, and payer communication.
- Evaluates contract terms and payer policies to determine expected reimbursement and validate payment accuracy.
- Supports identification of trends in reimbursement issues and escalates findings to appropriate stakeholders.
- Compiles and organizes data related to payment discrepancies and resolution activities.
- Collaborates with revenue cycle, finance, and clinical teams to address reimbursement issues and support process improvements.
- Reviews contract configurations and payer updates to support accurate reimbursement processes.
- Communicates findings and resolution status to internal stakeholders and leadership as needed.
- Maintains documentation of issues, actions taken, and outcomes to support reporting and process improvement efforts.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
Qualifications
- H.S. Diploma or GED required
- Associate Degree in Business, Healthcare Administration, or related field preferred
- 3-5 years of experience in healthcare revenue cycle, reimbursement, or related field required
- 1-3 years of experience working with payer contracts, claims, denials, or appeals processes required
- Experience with healthcare billing systems and data tools preferred
- Experience working in a multi-facility or shared services environment preferred
Knowledge, Skills and Abilities
- Strong understanding of healthcare reimbursement processes, payer contracts, and claims workflows.
- Ability to investigate discrepancies and determine appropriate resolution steps.
- Effective communication skills to coordinate with internal teams and external payer representatives.
- Ability to manage multiple priorities and maintain accuracy in a fast-paced environment.
- Strong attention to detail and organization in tracking and resolving payment issues.
The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.
Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.
Skills Required
- High school diploma or GED
- Associate degree in Business, Healthcare Administration, or a related field
- 3-5 years of experience in healthcare revenue cycle, reimbursement, or a related field
- 1-3 years of experience with payer contracts, claims, denials, or appeals processes
- Experience with healthcare billing systems and data tools
- Experience in a multi-facility or shared services environment
Community Health Systems Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Community Health Systems and has not been reviewed or approved by Community Health Systems.
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Healthcare Strength — Benefits are described as comprehensive, with medical, dental, vision, prescription coverage, mental health resources, wellbeing programs, and chronic-condition support. Feedback suggests insurance coverage is a frequent bright spot even when base-pay sentiment is more muted.
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Retirement Support — Offerings include a 401(k) and, in some cases, pension or profit sharing along with other financial-security benefits. Feedback suggests these options contribute to a perception of solid long-term support.
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Leave & Time Off Breadth — Paid time off, holidays, and volunteer time are included, alongside programs like tuition reimbursement. Feedback suggests the range of leave provisions is a meaningful part of the package.
Community Health Systems Insights
What We Do
Community Health Systems, Inc. is one of the nation’s leading operators of general acute care hospitals. The organization’s affiliates own, operate or lease more than 80 hospitals in 16 states with approximately 15,000 licensed beds. Affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities. Based on the unique needs of each community served, these hospitals offer a wide range of diagnostic, medical and surgical services in inpatient and outpatient settings.
