Physician Managed Care Analyst Contracts or Underpayments Remote

Conifer Physician Services • Frisco, TX

100d • $17 - $25

About The Position

The primary purpose of the Managed Care Analyst is to perform analysis of managed care contracts and agreements. This includes research on the specifics of doing business with our Managed Care clients. The position requires a solid understanding of government payors and other commercial/managed care carrier processes. The individual will be required to manage multiple projects and timelines.

Requirements

• 5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields.
• Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices.
• Knowledge of EPIC and IDX billing systems preferred.

Responsibilities

• Serve as primary analyst of managed care information, such as health plan specific policies, to internal departments.
• Conduct research to assist in development of policies and procedures, manuals, and other internal documentation when necessary.
• Maintain fee schedule and contract database by collecting client contracts and loading terms and preparing fee schedules.
• Analyze payment data related to client manage care contracts to ensure payor compliance.
• Communicate results to leader.
• Coordinate claim reprocessing projects when necessary.
• Research managed care contracts for negotiation purposes when necessary.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match.
• 10 paid holidays per year.
• Health savings accounts, healthcare & dependent flexible spending accounts.
• Employee Assistance program, Employee discount program.
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
• For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree