Managed Care Financial Analyst

Hackensack Meridian Health•Edison, NJ

About The Position

Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Managed Care Financial Analyst collaborates with Managed Care leadership to monitor payer policies and perform financial valuation to determine the potential impact to overall revenue. This position will collaborate with leadership regarding network initiatives by performing financial analytics. Perform high level analysis of accounts receivable to monitor the payer performance is in alignment with contractual terms.

Requirements

Bachelor's degree or equivalent experience with a High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
Minimum of 2 or more years of relevant experience.
Prior experience in Patient Financial Services/Patient Accounting Department or Managed Care Department for a University Medical Center, Hospital, or Health Insurance organization.
Knowledge of Managed Care contracts, Medicare and Medicaid.
Through knowledge of billing requirements and regulations of major payers.
Excellent written and verbal communication skills.
Proficient computer skills that include but are not limited to Google Suite and/or Microsoft Office platforms.

Nice To Haves

Strong analytical skills.
Reporting.
Epic Reporting Tools such as Reporting Workbench and Slicer Dicer.

Responsibilities

Review payer policy updates and perform financial valuation for revenue implications.
Identify, collect, integrate and analyze data from internal data sources and external sources (i.e. Medicare or Medicaid) by utilizing skills in data preparation, data transformation and data visualization.
Prepares statistical and financial data reports to enable management to accurately monitor payer performance.
Works with Revenue Cycle operations department and Digital Technical Services (DTS) systems analysts to ensure correct implementation of Managed Care contracts for appropriate reimbursement.
Analyzes payer reimbursement to ensure proper claim adjudication, track and report high volume discrepancies.
Analyze claims data to perform a root cause analysis surrounding the claim payment discrepancies to isolate if issue is an internal or external pricing issue.
Identify areas of concern impacting revenue by closely monitoring financial performance and compliance with managed care contract terms to ensure revenue maximization.
Work closely with Managed Care leadership in developing processes and workflows on trends to increase revenue.
Perform additional ad hoc projects as assigned.
Other duties and/or projects as assigned.
Adheres to HMH Organizational competencies and standards of behavior.