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Analyst-Mgd Care Reimbursement
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Job Description
- Req#: R26287
Employer Industry: Healthcare
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on managed care contract performance
- Work with a dedicated team focused on improving community health
- Access to resources for continuous learning and professional development
What to Expect (Job Responsibilities):
- Perform complex managed care analytical and operational functions
- Act as a liaison between contract management system administrators, Revenue Cycle, and Managed Care negotiators
- Resolve claims and related issues with managed care payors
- Update the Managed Care Systems and Business Office Legacy System accurately
- Calculate and audit expected reimbursement to determine payment accuracy
What is Required (Qualifications):
- Minimum educational requirement: High School Diploma or GED
- Minimum experience: Four (4) years of related managed care contracting and/or billing/collection experience in a hospital and/or managed care payor setting
- Knowledge of Microsoft Excel and other spreadsheet systems
- Understanding of billing practices, specifically revenue codes, CDM codes, and ICD-9 codes
- Excellent organizational and communication skills
How to Stand Out (Preferred Qualifications):
- Knowledge of SQL programs
- Familiarity with the contract negotiation process
- Experience in Third Party Healthcare Arrangements
- Ability to demonstrate respect for co-workers and promote teamwork
- Willingness to learn and act as a "System Administrator"
#Healthcare #ManagedCare #CareerOpportunity #Teamwork #ContinuousImprovement
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