Conifer Health Solutions
Physician Managed Care Analyst Contracts or Underpayments – Remote
Conifer Health Solutions, Frisco, Texas, United States, 75034
Overview
Physician Managed Care Analyst Contracts or Underpayments – Remote Join to apply for the Physician Managed Care Analyst Contracts or Underpayments – Remote role at Conifer Health Solutions. Job summary: The primary purpose of the Managed Care Analyst is to perform analysis of managed care contracts and agreements, with research on the specifics of doing business with Managed Care clients. The position requires a solid understanding of government payors and other commercial/managed care carrier processes. The individual will be required to manage multiple projects and timelines.
Responsibilities
Serve as primary analyst of managed care information, such as health plan specific policies, to internal departments.
Conduct research to assist in the development of policies and procedures, manuals, and other internal documentation when necessary.
Maintain fee schedule and contract database by collecting client contracts, loading terms, and preparing fee schedules.
Analyze payment data related to client managed care contracts to ensure payor compliance. Communicate results to leader.
Coordinate claim reprocessing projects when necessary.
Research managed care contracts for negotiation purposes when necessary.
Qualifications
5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields.
Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices.
Knowledge of EPIC and IDX billing systems preferred.
Knowledge, Skills, Abilities
Compliance with Laws, Policies and Procedures: Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines.
Communicates Effectively: Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker’s message without interruption. Tailors writing to audience using correct grammar and spelling.
Develops Self: Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development.
Drives for Results: Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Responds appropriately to urgent situations.
Plans and Organizes Effectively: Prioritizes tasks and goals. Manages time efficiently. Organizes information for easy access.
Analyzes Information: Determines information necessary to solve a problem. Identifies root causes.
Displays Adaptability: Performs well under pressure and in changing environments.
Focus on the Customer/Client: Ensures positive client experience and timely responses. Demonstrates tact and empathy.
Builds Effective Teams and Empowers Others: Fosters trust, delegates appropriately, and provides necessary information and resources.
Holds Others Accountable and Manages Conflict: Sets expectations, follows up, and resolves conflicts constructively.
Motivates Others and Builds Team Relationships: Inspires and collaborates with team members across departments.
Education / Experience
5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields.
Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices.
Knowledge of EPIC and IDX billing systems preferred.
Physical Demands
Must be able to work in sitting position, use computer and answer telephone.
Ability to travel.
Includes the ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments.
Work Environment
Office Work Environment
Hospital Work Environment
Compensation & Benefits
Pay: $17.20 - $25.70 per hour. Compensation depends on location, qualifications, and experience.
Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
Conifer observed holidays receive time and a half.
Benefits
Medical, dental, vision, disability, and life insurance
Paid time off (vacation & sick leave) – min of 12 days per year
401k with up to 6% employer match
10 paid holidays per year
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance
Colorado paid leave information where applicable
As part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients. We help our clients strengthen financial and clinical performance and succeed in the business of healthcare. Are you ready to be part of our solutions?
We offer a competitive benefits package and opportunities for career growth.
#J-18808-Ljbffr
Physician Managed Care Analyst Contracts or Underpayments – Remote Join to apply for the Physician Managed Care Analyst Contracts or Underpayments – Remote role at Conifer Health Solutions. Job summary: The primary purpose of the Managed Care Analyst is to perform analysis of managed care contracts and agreements, with research on the specifics of doing business with Managed Care clients. The position requires a solid understanding of government payors and other commercial/managed care carrier processes. The individual will be required to manage multiple projects and timelines.
Responsibilities
Serve as primary analyst of managed care information, such as health plan specific policies, to internal departments.
Conduct research to assist in the development of policies and procedures, manuals, and other internal documentation when necessary.
Maintain fee schedule and contract database by collecting client contracts, loading terms, and preparing fee schedules.
Analyze payment data related to client managed care contracts to ensure payor compliance. Communicate results to leader.
Coordinate claim reprocessing projects when necessary.
Research managed care contracts for negotiation purposes when necessary.
Qualifications
5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields.
Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices.
Knowledge of EPIC and IDX billing systems preferred.
Knowledge, Skills, Abilities
Compliance with Laws, Policies and Procedures: Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines.
Communicates Effectively: Expresses ideas clearly and succinctly with small or large audiences. Listens attentively to speaker’s message without interruption. Tailors writing to audience using correct grammar and spelling.
Develops Self: Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development.
Drives for Results: Delivers high quality work and attains results. Demonstrates personal drive and pushes self and others for results and quality work. Responds appropriately to urgent situations.
Plans and Organizes Effectively: Prioritizes tasks and goals. Manages time efficiently. Organizes information for easy access.
Analyzes Information: Determines information necessary to solve a problem. Identifies root causes.
Displays Adaptability: Performs well under pressure and in changing environments.
Focus on the Customer/Client: Ensures positive client experience and timely responses. Demonstrates tact and empathy.
Builds Effective Teams and Empowers Others: Fosters trust, delegates appropriately, and provides necessary information and resources.
Holds Others Accountable and Manages Conflict: Sets expectations, follows up, and resolves conflicts constructively.
Motivates Others and Builds Team Relationships: Inspires and collaborates with team members across departments.
Education / Experience
5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields.
Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices.
Knowledge of EPIC and IDX billing systems preferred.
Physical Demands
Must be able to work in sitting position, use computer and answer telephone.
Ability to travel.
Includes the ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments.
Work Environment
Office Work Environment
Hospital Work Environment
Compensation & Benefits
Pay: $17.20 - $25.70 per hour. Compensation depends on location, qualifications, and experience.
Position may be eligible for a signing bonus for qualified new hires, subject to employment status.
Conifer observed holidays receive time and a half.
Benefits
Medical, dental, vision, disability, and life insurance
Paid time off (vacation & sick leave) – min of 12 days per year
401k with up to 6% employer match
10 paid holidays per year
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance
Colorado paid leave information where applicable
As part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients. We help our clients strengthen financial and clinical performance and succeed in the business of healthcare. Are you ready to be part of our solutions?
We offer a competitive benefits package and opportunities for career growth.
#J-18808-Ljbffr