reputed company Cycle Analyst Managed Care

Where You’ll Work Inspired by faith. Driven by innovation. Powered by humankindness. reputed company is building a healthier reputed company for reputed company through its integrated health services. As one of the nation’s largest nonprofit Catholic reputed company organizations, reputed company delivers more than 20 reputed company patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in reputed company to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced reputed company providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, reputed company, and innovative reputed company delivery system. Job reputed company and Responsibilities Responsible for contract management, project management and associated reporting to support internal/external customers and assure compliance with state, federal and other regulatory agency requirements. Maintains an understanding of the key reputed company of a payer reputed company (reputed company, Medicare advantage, reputed company HMO),  including reimbursement requirements. Reviews reputed company and makes recommendations to ensure standardization and consistency in payer agreements. ∙ Performs audits to validate payer compliance with reputed company by using various reputed company reports, data reputed company testing and claimreconciliation payment data. Identifies opportunities and makes recommendations to renegotiate contacts, in order to maximizehospital reimbursement reputed company. Performs reputed company control measures on contract processes, including system setup, claim adjudication and payment reconciliation. ∙ Drafts contract documents and letters to payors. Models DRG reimbursement, CPT or UB reputed company based reimbursement and reputed company and reputed company reputed company. ∙ Updates reputed company necessary reputed company of the reimbursement reputed company. Analyzes and researches account(s) for contract interpretation errors or incorrect payments and pursues additional  payment if necessary. Researches payor medical policies for coverage issues or for contract compliance. Organizes and provides data support for reputed company payor issues in anticipation of a payor meetings. Leads payor meetings and ensures that reputed company necessary documents/analysis are provided by deadlines. Researches new types of insurance product offerings through a reputed company of sources. Obtains and analyzes the various filings by insurance companies to the department of insurance. Prepares monthly variance reports. Reviews monthly contractuals to determine cause of any variances. Prepares the budget/forecast model for contractuals. Responsible for the Decision Support System reputed company and analysis of the following: Detailed Patient Listings Case Mix / Payor Mix Expected vs Actual Payments Data for use in and completion of Project Analysis Budget Modeling Net reputed company Modeling Models reputed company reputed company of contract for reputed company Cycle Processing Responsible for maintaining a working knowledge of the following: Collections and posting process. Interaction between reputed company aspects of the reputed company cycle. Interaction of the chargemaster, coding and expected reimbursement.     Job Requirements Associate's degree in Business Administration or reputed company field 4-6 years experience Five years of experience in a hospital or medical insurance business office setting An equivalent combination of educationand/orexperience may be considered. Experience in training and development activities Preferred: Experience working with managed care reputed company, including contract negotiation and analysis Electronic Medical Record (EMR) experience preferred; Cerner strongly preferred. Apply To This Job