Data / Rates Analyst

VITAS Healthcare•Miramar, FL

About The Position

The Rates Analyst is responsible for managing rates in the industry and keeping up to date research to maintain corporate strategy, preparation, and execution for VITAS’ current and future healthcare services: hospice, physician, nursing home, respite, & claims payments. Administer the dissemination of rates information and the training of corporate, program, and department employees. Provide additional support for the managed care business and vendor auditing requirements. Research and update nursing home state rates, Medicare, and Medicaid physician rates as communicated by State entities for each program and CMS Analyze, evaluate and disseminate to Accounts Payable payment rate information related to: ambulance, anesthesia, drugs, x-rays, DME, laboratory, and surgery fee schedules. Monitor and coordinate between VITAS Information Technology, Revenue Cycle Management, and Accounts Payable to ensure rates system integrity and accuracy. Process and maintain contracted managed care insurance plans. Maintain geographic tables for program billing and prepare reports to monitor and identify trends. Utilize well-documented, trusted facts and sources upholding excellent research skills. Identify improvement processes and recommendations to create and maintain organizational effectiveness within the department. Resolve issues while keeping abreast of the changes in industry rates/trends to maintain corporate strategy within the business function. Analyze state and legal requirements to ensure compliance with law, regulations, corporate, and business policies and procedures. Forecast predictions that may affect rates to remain aligned with the strategic direction of the business. Assist with vendor audit requests.

Requirements

Three to five years’ relevant experience in healthcare, accounting/billing, statistics, or related fields
Working knowledge of Medicare, Medicaid, and reimbursement processes
Excellent communication and analytical skills
Ability to lead, providing subject matter guidance to team members in a positive and productive manner by motivating and developing colleagues
Ability to work on various assignments simultaneously
Strong interpersonal skills within all levels of the organization
Ability to navigate within automated systems and proficiency in Outlook, Word and Excel
Associate’s degree in healthcare/business administration, accounting or related fields from an accredited college or university or the international equivalent required

Responsibilities

Managing rates in the industry
Keeping up to date research to maintain corporate strategy
Preparation, and execution for VITAS’ current and future healthcare services: hospice, physician, nursing home, respite, & claims payments
Administer the dissemination of rates information
Training of corporate, program, and department employees
Provide additional support for the managed care business and vendor auditing requirements
Research and update nursing home state rates, Medicare, and Medicaid physician rates as communicated by State entities for each program and CMS
Analyze, evaluate and disseminate to Accounts Payable payment rate information related to: ambulance, anesthesia, drugs, x-rays, DME, laboratory, and surgery fee schedules
Monitor and coordinate between VITAS Information Technology, Revenue Cycle Management, and Accounts Payable to ensure rates system integrity and accuracy
Process and maintain contracted managed care insurance plans
Maintain geographic tables for program billing and prepare reports to monitor and identify trends
Utilize well-documented, trusted facts and sources upholding excellent research skills
Identify improvement processes and recommendations to create and maintain organizational effectiveness within the department
Resolve issues while keeping abreast of the changes in industry rates/trends to maintain corporate strategy within the business function
Analyze state and legal requirements to ensure compliance with law, regulations, corporate, and business policies and procedures
Forecast predictions that may affect rates to remain aligned with the strategic direction of the business
Assist with vendor audit requests