Analyst, Managed Care Contracting

Description

About Us:

We are a leading Revenue Cycle Management (RCM) firm dedicated to providing innovative solutions to healthcare providers. Our expertise spans across Transcription, Coding, Billing, and Analytics, enabling our clients to optimize their operations and enhance financial performance. We are committed to leveraging cutting-edge technology to improve healthcare efficiency and outcomes.

Job Summary: 

The Managed Care Contracting Analyst is responsible for implementing and maintaining National Medical’s managed care contracting strategy in a multi-state environment. 

Primary Duties:

· Manage and maintain accurate files for each pending and executed managed care contract and provide network updates as required.

· Assist in resolving billing or other contractual problems with insurance carriers on behalf of clients.

· Develop strategies to increase reimbursement opportunities.

· Actively evaluate and negotiate managed care contracts with health plans, hospitals/health care systems, medical groups/IPA's, government programs and other payers

· Analytics reporting and management of contracted rates within client software. 

Requirements

Education and Experience:

· Bachelor’s degree in business or health administration OR 2 years of experience in a managed care environment 

· Proficiency and experience using Microsoft Office applications.

· Computer knowledge.

· Managed Care Contracting and payment models. 

Skills Required:

· Excellent interpersonal skills with the ability to interact effectively with all levels of employees and clients.

· Excellent written and verbal communication skills.

· Strong organizational skills.

· Detail oriented.

· Ability to analyze and problem solve with accuracy and attention to detail.

· Ability to prioritize and oversee multiple tasks simultaneously.

· Ability to work in a team-oriented environment.

· Knowledge of Health Care industry.

· Knowledge of and ability to comply with HIPAA, confidentiality policies (both medical and financial).

· Strong knowledge of Microsoft Office applications, including Excel, Word and Teams.

· Cooperative work attitude toward and with co-employees, management and outside contacts.

Work Environment:

· Office setting – This is an onsite position only. 

· Participates in departmental, training, and staff meetings.

· Adhere to all compliance and company policies and procedures.

Physical Demands:

· Uses telephone, computer keyboarding including the ten key function, fax, and copier equipment.

· Works on company provided computer.

· Ability to work in a moderately noisy environment with frequent interruptions.

· Ability to remain seated for majority (up to 7hours)of the day in a cubicle setting with general office lighting.

Ability to perform other job duties upon request as needed.