Managed Care Sr Analyst
Maintains a professional image and exhibits excellent customer relations to patients, visitors, physicians, and co-workers in accordance with our Service Excellence Standards and Core Values.
Maintains the managed care contract database by accurately loading contract schedules.
Performs audits on managed care contract database to ensure that accounts are calculating accurately
Analyzes managed care data leading to the development of contract strategy
Develops contract models to evaluate current contract performance yields and constructs new contract models during the evaluation of contract proposals
Generates weekly reports to communicate productivity, recovery, and underpayment opportunities to Director.
Works with IT and Contract Management vendor to ensure that data validation of the imports occurs correctly.
Completes facility credentialing required by contracted managed care payers.
Work Schedule: 80 hours bi-weekly
Preferred Qualifications /Training:
- 3 years of experience in healthcare finance
- Experience with data manipulation, word processing, spreadsheets, and data analysis to report trends, patterns, and statuses. Must be proficient with Microsoft Excel.
- Working knowledge of managed care terminology, managed care reimbursement methodologies, and billing/coding terminology (i.e ICD-10, CPT, Revenue Code)
- Working knowledge of Patient Financial Services.
- Excellent interpersonal, written and organizational skills required.
- Experience in a progressive healthcare environment with responsibilities for data analysis preferred. Attention to detail and accuracy skills required.
- Report writing (i.e. Crystal Reports, Microsoft Access) experience
- Must be flexible, able to work independently and able to achieve deadlines and deliverables with minimal supervision.
- Experience with problem solving techniques required.
Associates Degree in Business/Healthcare/Computer Science
In lieu of degree, must possess a High School Diploma with 8 years of experience in healthcare finance.
Florence, SC, United States