Revenue Analyst II

Altais

4d • $62,250 - $74,700

About The Position

Are you looking to join a fast-growing, dynamic team? We’re a collaborative, purpose-driven group that’s passionate about transforming healthcare from the inside out. At Altais, we support one another, adapt quickly, and work with integrity as we build a better experience for physicians and their patients. The Revenue Analyst II is responsible for receiving, reconciling and reporting monthly health plan capitation revenue & membership data. Performs monthly and retroactive audit, assessment and analysis of data to ensure that health plan revenue and membership have been received in accordance with the health plan contracts.

Requirements

• Bachelor’s degree from an accredited program or relative career experience.
• Course work or equivalent experience in finance, accounting, business and health care required.
• One to three years experience in healthcare industry and/or finance position and/or or insurance environments.
• Knowledge of managed care industry and healthcare billing practices: Must be accurate, detail oriented with excellent analytical skills and ability to handle variety of financial functions.
• Ability to work independently.
• Capacity to work with all levels of personnel.
• Excellent verbal and written communication skills, PC proficiency using Databases, Microsoft Excel, Word and Access required.
• Ability to research, retrieve and organize data to prepare reports and financial documentation; analyze and audit data to detect, identify and correct errors; operate standard office equipment; ability to accurately perform complex mathematical computations when required; ability to organize and maintain accurate accounting records.
• Creative, Problem-solving, and Innovation Skills: Ability to organize work to meet strict deadlines; coordinate a variety of projects simultaneously; communicate effectively in both oral and written form. Must be able to work independently or as part of a team; must be able adapt to changing department needs; ability analyze complex health plan rules, regulations and policies.
• Customer Focused and Communication Skills: Must have good written and oral skills. Ability to establish and maintain positive working relationships with internal and external clients; be able to explain revenue and membership details clearly and concisely.

Responsibilities

• Responsible for ensuring monthly receipt of multiple health plans (including BTHS) capitation payments, files and remittance summaries and that they meet compliance with contractual terms as outlined in the health plan contracts.
• Responsible for performing contractual reconciliations, including EPIC and internal databases, and/or audits on capitation revenue changes which may require extensive research.
• Develop requests to health plans for underpayments related to eligibility or rate issues and track activity to ensure successful outcomes.
• Communicate results, pursue and track capitation revenue until the revenue is received and according to Health Plan contracts.
• Perform quantitative analysis on revenue data (including risk adjustments and RAF data); evaluate results and report on health plan monthly revenue by product type and/or other key indicators.
• Perform quantitative analysis on membership and distribute management reporting; evaluate results and report on health plan monthly membership by product type and/or other key indicators.
• Validate health plan data repository through knowledge of data sources or tools (e.g. Cognos, Access, and plan websites) on all health plan capitation revenues and membership reporting.
• Prepares individual health plan analysis and reports on revenue and membership as required or requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level