Managed Care Analyst I

Sarasota Memorial Health Care System • Sarasota, FL

3d

About The Position

The Managed Care Analyst I is responsible for collecting and reconciling underpayments on managed care contracts and maintaining a log of their collection status. The analyst maintains and continually updates the department training manual and provides weekly and monthly collection reports to the Manager. The role also involves completing proactive projects focused on problem areas and high-cost services to maximize contractual reimbursement. The analyst must understand contract reimbursement methods and use PMMC for contract management reporting, while developing strong relationships with insurance carriers to address multiple underpayments from a payer.

Requirements

• At least five years of collections or healthcare-related experience within a healthcare setting; a bachelor’s degree may substitute for the required work experience.
• High school diploma, GED, or certificate.

Nice To Haves

• Certified Patient Account Technician (CPAT) or Certified Revenue Cycle Specialist (CRCS).
• Demonstrated analytical skills.
• Demonstrated computer skills in spreadsheet databases, word processing, PMMC, and other applications.
• Strong interpersonal skills, including the ability to handle difficult situations diplomatically.
• Ability to type at least 45 words per minute.
• Associate’s degree.

Responsibilities

• Collect and reconcile underpayments on managed care contracts.
• Maintain a log of the current status of underpayments collected.
• Maintain and continually update the department training manual.
• Provide weekly and monthly collection reports to the Manager.
• Complete proactive projects focused on problem areas and high-cost services to ensure maximum contractual reimbursement.
• Understand reimbursement methods by contract and use PMMC for contract management reporting.
• Develop strong relationships with insurance carriers to address multiple underpayments by a payer.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED