Managed Care Analyst I

Mass General Brigham • Somerville, MA

1d • $52,000 - $74,402 • Remote

About The Position

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Under direction of the Manager, the Managed Care Analyst I will be responsible for identifying payment variances, collecting underpayments from third party payers, and notifying management when overpayments are detected. Will also be responsible for identifying payment trends, calculating impact and reporting findings to manager. Will interact with Mass General Brigham Finance staff and payor liaisons to understand root causes and make recommendations for resolution that will maximize future reimbursement.

Requirements

• Associate's Degree Related Field of Study required
• Experience in accounting or finance 2-3 years required
• Possess strong interpersonal skills to effectively communicate with cross functional teams including staff at all levels of the organization
• Ability to successfully interact and collaborate with others of different skill sets, backgrounds and levels within and external to the organization
• Knowledge of Third Party billing rules and reimbursement methodologies
• Strong financial analytical, problem solving and negotiation skills
• Ability to effectively conduct meetings, both formal and informal
• Proficient with Excel

Nice To Haves

• Bachelor's Degree Related Field of Study preferred
• Experience in a role within a large healthcare organization 2-3 years preferred
• Access a plus
• Experience with contract modeling tool (FinThrive or Experian a plus)

Responsibilities

• Independently and accurately, analyze third party payment variances and determine root causes for discrepancies, utilizing database tools in a timely manner
• Resolve underpayment variances directly with payors when indicated
• Provide qualitative reporting to manager on overpayments
• Provide continuous feedback to manager
• Participate in payor operations and revenue analyses meetings internally and externally as necessary
• Compile summary variance reports for Management
• Act as liaison between Payer Variance team and our zero balance vendors – responsibilities may include, but are not limited to, contract research, payer escalations, invoice management, etc.
• Actively participate in process improvement initiatives including, but not limited to the MGB RCO ‘ESP – Everyone Solves Problems’ initiative
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree