Associate Managed Care Analyst

Company :

Allegheny Health NetworkJob Description :

GENERAL OVERVIEW:

This job builds and maintains hospital, professional, and ASC contracts in Epic. Identifies underpaid accounts and articulates the source of the processing error to the payor.

ESSENTIAL RESPONSIBILITIES

• Provides support to senior analysts in building hospital, professional, and ASC contracts in Epic. (40%)

• Manages underpayment AR for assigned payors including successfully recovering on underpaid accounts. (25%)

• Collaborates with Revenue Cycle and Finance Teams on contract building and analysis requests. (25%)

• Provides assistance in performing analyses to support reimbursement impact analysis. (10%)

• Perform other duties as assigned or required.

QUALIFICATIONS:

Minimum

• Associate's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field

• Experience in finance, contracting, or data analysis

• Microsoft Office (Excel, PowerPoint, etc.)

• Ability to analyze and interpret various types of data including financial results, operational metrics, clinical outcomes, and other key datasets

• Ability to work with large quantities of detailed data and illuminate the higher-level strategic insights that can impact business operations and performance

• Ability to juggle multiple projects at once and manage time effectively, in order to meet established deadlines

• Strong oral and written communication skills

• Ability to independently make progress on key projects with support from supervisor or peer analysts

Preferred

• Bachelor's degree in Finance, Accounting, Business Administration, Economics, Statistics, or Related Field

• Epic Expected Reimbursement Contracts Certification

• Experience with hospital, physician, and ASC contracts

• Experience in healthcare

• R, Python, or other statistical/programming tools

• Knowledge of healthcare industry, particularly as it relates to hospitals or other providers reimbursement methodologies

• Clinical background or general understanding of hospital/physician practice operations

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$34.29Pay Range Maximum:

$54.25Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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Originally posted on Himalayas