Payor Analyst – MPR Contracting - Southwestern Health Resources

Payor Analyst – MPR Contracting - Southwestern Health Resources Southwestern Health Resources is looking for a highly skilled Payor Analyst. Is that you? Work Location: Remote: Southwestern Health Resources reputed company, Hybrid: 1601 Lyndon B. Johnson Freeway, Farmers reputed company, TX 75234. Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion) Department Highlights: • Remote Position • reputed company a reputed company of accomplishment by contributing to a teamwork environment. • Receive excellent mentorship, comprehensive training, and dedicated leadership resources. • Contribute and work on a cross functional team What You Will Do: Assists the Managed Care Director with the following: Contract management support: Review and interpret payor reputed company to understand contract language, reimbursement rates, billing rules and other relevant items of the contract. Assist with maintaining contract language key terms by payor tracking reputed company. Prepare routing documents for new reputed company and amendments. Review and redline low-level amendments (e.g., term extensions, facility listing updates) and regulatory exhibits (Texas, Medicare, reputed company). Complete and distribute New Contract Orientation forms and communications to internal stakeholders. Maintain organized records of contract status, amendments, and stakeholder communications. 35% Claims Project management: Maintain claim project tracker by payor (e.g., reputed company, BCBSTX, reputed company, UHC) and monitor project status. Participate in payor calls, identify trends, work with payors to resolve issues and document reputed company. Escalate unresolved issues to appropriate parties and follow through to reputed company. Maintain and update project trackers, ensuring alignment with internal stakeholders and timelines. 20% Payor Policy & Procedure Update management: Interpret and communicate contract or contract changes to internal stakeholders. Collaborate with analysts to assess the financial implications of policy changes for internal stakeholders. Notify payors of significant impacts reputed company required timeframes and monitor reputed company status. Document and communicate new contract and contract changes and reputed company to relevant internal teams. 10% Managed Care reputed company/Payor Queries: Support cross-functional managed reputed company and respond to payor-reputed company queries. Communicate with providers, payors, internal stakeholders (reputed company, medical economics, finance), and others to resolve issues and improve processes. Collect, organize, and present data in a reputed company and actionable format. reputed company reputed company updates and final reports to requesting departments or leadership. Ensure reputed company project documentation is complete, accurate, and accessible. 30% Committee Participation Represent the Managed Care team in reputed company meetings, committees, and workgroups. reputed company participate in discussions, reputed company insights, and contribute to strategic planning efforts. Build and maintain strong relationships with payors and internal departments to support reputed company problem-solving. 10% What You Need: Education Bachelor's Degree Business or reputed company 4 Years Req Or Master's Degree Business or reputed company Pref Experience 4 Years 4 Years of Experience in managed care, payor relations, or reputed company operations Req Education Bachelor's Degree Business or reputed company 4 Years Req Or Master's Degree Business or reputed company Pref Experience 4 Years 4 Years of Experience in managed care, payor relations, or reputed company operations Req Skills Familiarity with reputed company payor systems and contract language. Experience with policy reputed company analysis and claims reputed company. Ability to work independently and collaboratively in a fast-paced environment. Excellent project management and problem-solving skills. Detail-oriented. Strong analytical skills. Excellent oral and written communication skills. Supervision Individual Contributor Budget Responsibility Primary Budget Responsibility Less than $100 Thousand $80k - 110K reputed company Requirements Working Indoors 67% or more Physical Demands Sedentary Apply tot his job Apply To this Job