(RCM) Master Data Management Analyst

United Vein & Vascular Centers•Tampa, FL

About The Position

The RCM Master Data Management (MDM) Analyst is responsible for maintaining integrity, accuracy, governance, and standardization of payer, insurance plan, and fee schedule master data across Revenue Cycle operations. This role serves as the central owner of insurance master file management, payer configuration, fee schedule assignment, reimbursement mapping, and data governance processes to ensure accurate eligibility verification, claims processing, reimbursement, reporting, and regulatory compliance.

Requirements

3+ years of Revenue Cycle Management experience.
2+ years of payer configuration, insurance master file management, reimbursement analysis, managed care, or healthcare data governance experience.
Experience working within EMR/PM systems (eCW preferred).
Strong communication, leadership, and problem-solving skills
Proficiency with billing systems and strong knowledge of Microsoft Excel
Excellent written and verbal communication skills, including the ability to present ideas and concepts effectively
Leads by example, promotes teamwork by fostering a positive, transparent, and focused working environment which achieves maximum results.
Highly dependable; able to meet reliable attendance and punctuality standards for the role.

Nice To Haves

Experience managing payer contracts, fee schedules, and reimbursement methodologies preferred.

Responsibilities

Maintains and governs the organization's insurance plan master files.
Creates, updates, consolidates, and retires insurance records in accordance with established naming standards and governance rules.
Ensures standardized insurance naming conventions are consistently applied across all payer records.
Works closely with leadership to ensure the department’s activities and priorities are aligned with departmental goals and objectives, communicates expectations to the team, and supports initiatives that drive operational efficiency, productivity, and financial performance.
Reviews and approves insurance master file changes in collaboration with Revenue Cycle leadership.
Manages governance workflows for new payer and insurance product requests.
Serves as the primary owner of payer setup and configuration standards.
Validates billing payer IDs and eligibility payer IDs against clearinghouse requirements.
Maintains payer-to-fee schedule assignments and reimbursement mapping.
Evaluates new insurance plans to determine appropriate fee schedule assignment.
Conducts variance analysis to identify reimbursement issues related to configuration errors.
Investigates payment variances, underpayments, and denial trends related to payer setup or fee schedule assignments.
Collaborates with Revenue Cycle teams to resolve payer configuration issues impacting reimbursement.
Identifies opportunities to improve automation, standardization, and data quality across revenue cycle systems.
Maintains master data governance policies, procedures, and standards.
Leads ongoing payer master file review meetings and exception management activities
Demonstrates and promotes a work culture committed to UVVC’s Core Values: understanding, nurturing, ingenuity, trust, excellence, and diversity, equity and inclusion.
Maintain the confidentiality and security of Protected Health Information (PHI) in accordance with UVVC policies, the Health Insurance Portability and Accountability Act (HIPPA), and other applicable laws and regulations.
Other related duties as assigned