About the Role
<p>We are an acute care medical center and a member of a large academic neighboring Health System looking for a Managed Care Analyst with Inpatient Hospital experience to join our fast-paced growing team. As the Managed Care Analyst with Inpatient Hospital experience you will be responsible for assisting in the analytics, reporting, trending, and validation of reimbursement from third party plans in relation to the hospital’s negotiated fees and adherence to contract terms. You will be involved with developing and maintaining relationships with payer provider representatives, as well as maintaining the provider escalation process and file maintenance.</p>
<p>Position: Managed Care Analyst – Inpatient Hospital<br />
Location: White Plains, NY<br />
Hours: Mon-Fri 8 am-4 pm<br />
Salary: $80,000 – $100,000 </p>
<p>Responsibilities:</p>
<p>Provides support for special projects which include collecting, analyzing, and modeling claim data in preparation for payer contract negotiations at least four months in advance of contract renewal<br />
Analyzes reimbursement utilizing appropriate rates based on contract structure and assists in testing and maintenance of contracts, including fee schedules in host system and contract software tools.<br />
Performs audits and reconciliation of plan payments to contract terms, identifying any variance and communicating to leadership and managed care team issues identified while working with third party payers to rectify contract discrepancies<br />
Maintains knowledge of all aspects of third-party reimbursement policies and practices and tracks, trends, and reports out on all initiatives and projects to senior leadership.</p>
<p>Requirements:</p>
<p>Must have a Bachelor’s Degree<br />
Minimum of (2) to (4) years in Patient Accounting required, in a hospital setting.<br />
3 years of demonstrated strong analytical skills with knowledge of patient accounting, third party contracting, and/or contract modeling systems or healthcare reimbursement<br />
Proficiency with Microsoft office/excel to include reporting, Executive level required</p>