- 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.
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.
LICENSES/CERTIFICATIONS/REGISTRATIONS/EDUCATION:
- 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.
Required Skills
Required Experience