Bronson Healthcare
CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicants only.
Love Where You Work!
Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.
If you're ready for a rewarding new career, join Team Bronson and be part of the experience.
Location BHG Bronson Healthcare Group
Title Managed Care Analyst
Under supervision of the System Manager, the Contract Audit Analyst is responsible for managing the ongoing review of actual payor payments versus expected payments through the process of routine retrospective auditing of payments. The Contract Audit Analyst develops auditing schedules, tracking mechanisms and coordinates the pursuit of the recovery of net revenue, rebilling of claims and/or settlement opportunities. Through the ongoing auditing process, the Contract Audit Analyst may identify enhancements required to Epic contract models and/or opportunities for education within the Revenue Cycle team as a result of denials trends. The position is responsible for following up with recommendations to change contract models and works collaboratively with the team to enhance processes to minimize denials. A thorough understanding of payor contracts and relevant documents to payor reimbursement, coverage and authorization policies is required. This position manages the Managed Care Payor Contracting database and develops automated reports to generate key terms as required to ensure timely and thorough contract management. Employees providing direct patient care must demonstrate competencies specific to the population served.Bachelor's degree in Finance, Accounting, Business Administration or related field preferred, or 2-3 years of comparable work experience.
• Understanding of billing and reimbursement methodologies and concepts common to payor reimbursement techniques; such as DRGs, per diem rates, case rates, fee schedules, APCs, etc. • Intermediate excel skills and Microsoft Office suite proficiency • Diagnosis and procedural coding knowledge • Generate reports and analysis for management, clearly communicating interpretations in a manner that summarizes findings and recommendations to various levels of management. • Maintains a collaborative relationship with peers and Revenue Cycle teams to share information regarding payor auditing results and potential process improvements. • Develops excellent working relationships with payors in order to achieve maximum outcomes. • Excellent customer service skills, both oral and written in order to respond appropriately to managers and internal customers. • Ability to negotiate priorities and act on deliverables and timeframes.
Work which produces very high levels of mental/visual fatigue, e.g. CRT work between 70 and 90 percent of the time, and work involving extremely close tolerances and considerable hand/eye coordination for sustained periods of time. The job produces some physical demands. Typical of jobs that include regular walking, standing, stooping, bending, sitting, and some lifting of light weight objects. • Contributes to annual revenue enhancement targets through routine auditing of payer contracts and pursuing recovery of underpayments. • Develops an effective process and schedule for auditing of payor payments and holds payors accountable to contract terms. • Creates routine tracking mechanisms and reporting for payor auditing results, analytics and contract database terms. • Interprets and thoroughly understands all payer contract documents including payer reimbursement methods and provider manuals to calculate expected rates of reimbursement. • Assists in the collection, preparation and analysis of payor fee schedules for dataloading into various contract models to ensure that payment calculations are accurate. • Maintains the departmental contract management database and coordinates any associated reporting. • Acts as a back-up for departmental analysis related to payor reimbursement and incentives. • Routinely participates in Epic user payor reimbursement related groups, webinars and other educational resources to enhance understanding of current developments in healthcare finance and delivery. • Documents department procedures to streamline tasks, improve productivity and succession training. • Contributes to a positive working environment and performs all duties as assigned to enhance the overall efforts of the organization.
Shift First Shift
Time Type Full time
Scheduled Weekly Hours 40
Cost Center 1222 Revenue Cycle Business Analytics (BHG)
Agency Use Policy and Agency Submittal Disclaimer
Bronson Healthcare Group and its affiliates ("Bronson") strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration.
Please take a moment to watch a brief video highlighting employment with Bronson!
Love Where You Work!
Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.
If you're ready for a rewarding new career, join Team Bronson and be part of the experience.
Location BHG Bronson Healthcare Group
Title Managed Care Analyst
Under supervision of the System Manager, the Contract Audit Analyst is responsible for managing the ongoing review of actual payor payments versus expected payments through the process of routine retrospective auditing of payments. The Contract Audit Analyst develops auditing schedules, tracking mechanisms and coordinates the pursuit of the recovery of net revenue, rebilling of claims and/or settlement opportunities. Through the ongoing auditing process, the Contract Audit Analyst may identify enhancements required to Epic contract models and/or opportunities for education within the Revenue Cycle team as a result of denials trends. The position is responsible for following up with recommendations to change contract models and works collaboratively with the team to enhance processes to minimize denials. A thorough understanding of payor contracts and relevant documents to payor reimbursement, coverage and authorization policies is required. This position manages the Managed Care Payor Contracting database and develops automated reports to generate key terms as required to ensure timely and thorough contract management. Employees providing direct patient care must demonstrate competencies specific to the population served.Bachelor's degree in Finance, Accounting, Business Administration or related field preferred, or 2-3 years of comparable work experience.
• Understanding of billing and reimbursement methodologies and concepts common to payor reimbursement techniques; such as DRGs, per diem rates, case rates, fee schedules, APCs, etc. • Intermediate excel skills and Microsoft Office suite proficiency • Diagnosis and procedural coding knowledge • Generate reports and analysis for management, clearly communicating interpretations in a manner that summarizes findings and recommendations to various levels of management. • Maintains a collaborative relationship with peers and Revenue Cycle teams to share information regarding payor auditing results and potential process improvements. • Develops excellent working relationships with payors in order to achieve maximum outcomes. • Excellent customer service skills, both oral and written in order to respond appropriately to managers and internal customers. • Ability to negotiate priorities and act on deliverables and timeframes.
Work which produces very high levels of mental/visual fatigue, e.g. CRT work between 70 and 90 percent of the time, and work involving extremely close tolerances and considerable hand/eye coordination for sustained periods of time. The job produces some physical demands. Typical of jobs that include regular walking, standing, stooping, bending, sitting, and some lifting of light weight objects. • Contributes to annual revenue enhancement targets through routine auditing of payer contracts and pursuing recovery of underpayments. • Develops an effective process and schedule for auditing of payor payments and holds payors accountable to contract terms. • Creates routine tracking mechanisms and reporting for payor auditing results, analytics and contract database terms. • Interprets and thoroughly understands all payer contract documents including payer reimbursement methods and provider manuals to calculate expected rates of reimbursement. • Assists in the collection, preparation and analysis of payor fee schedules for dataloading into various contract models to ensure that payment calculations are accurate. • Maintains the departmental contract management database and coordinates any associated reporting. • Acts as a back-up for departmental analysis related to payor reimbursement and incentives. • Routinely participates in Epic user payor reimbursement related groups, webinars and other educational resources to enhance understanding of current developments in healthcare finance and delivery. • Documents department procedures to streamline tasks, improve productivity and succession training. • Contributes to a positive working environment and performs all duties as assigned to enhance the overall efforts of the organization.
Shift First Shift
Time Type Full time
Scheduled Weekly Hours 40
Cost Center 1222 Revenue Cycle Business Analytics (BHG)
Agency Use Policy and Agency Submittal Disclaimer
Bronson Healthcare Group and its affiliates ("Bronson") strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration.
Please take a moment to watch a brief video highlighting employment with Bronson!