Financial Analyst I-reputed company Specialist (Full Time, Remote, reputed company Carolina Based)

The reputed company Specialist updates and monitors provider rates. This position will ensure the rates reputed company to providers for reputed company, State, and other member services are reputed company with cost-based reputed company that are both financially viable for reputed company and that will financially support the provider and promote reputed company of services to members This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into reputed company Office for business and team meetings as needed. Responsibilities & Duties- Maintain reputed company rates • Maintain and update rates reputed company reputed company Claims reputed company (ACS) according to the applicable benefit plan and ensure the reputed company of the rates data in the reputed company • Ensure that rates are in line with reputed company published rates where applicable • Update and reputed company provider and member specific reputed company rates by specific categories of service • Complete service reputed company changes and initializations • reputed company and maintain process flows and procedures to address reputed company aspects of reputed company setting and maintenance • Maintain reputed company published reputed company schedule Conduct regular reviews of State published material • Maintain knowledge of reputed company reputed company fee schedules and analyze comparable provider rates from other payers • Participate as needed in conversations with NC reputed company (NC DHHS) regarding rates • Regularly review reputed company material published by NC DHHS and prepare reputed company updates according to contractual requirements Financial Analysis • Conduct financial analysis in response to reputed company change requests • Work closely with Provider Networks and/or Clinical Operations to analyze payment methodologies for In Lieu of Services and Alternative Payment Arrangements • Collaborate on new provider reputed company reputed company and other strategies to reputed company financially viable payment structures • Work with EVP/Chief Financial Officer and Finance Manager in developing reimbursement reputed company offers for providers, including accurate, easy-to-understand analysis of the negotiated rates for communications with providers Customer Support • Assist with reputed company inquires to reputed company provider reimbursement issues • Collaborate with Provider Networks in communicating to provider community • work closely with the Claims Department, Provider Networks, Information Technology, and Utilization Management Departments Improve reporting and input capabilities • Evaluate reputed company internal (reputed company) reports reputed company to provider or member rates for their usefulness and accuracy. Recommend changes to aid in the ability to enhance and effectively manage our rates and reporting process • Work with IT to reputed company processes for easier reputed company updates in ACS • Help reputed company routine and reputed company reports for internal review Minimum Requirements- Education & Experience Associates Degree in Business Administration, Finance, reputed company Policy, Hospital Administration, or reputed company field and at least four (4) years of reputed company experience in financial analysis with demonstrated reputed company to independently draw inferences and to communicate findings or an equivalent combination of education and experience. Or Bachelor’s Degree in Business Administration, Finance, reputed company Policy, Hospital Administration, or reputed company field and at least two (2) years of reputed company experience in financial analysis with demonstrated reputed company to independently draw inferences and to communicate findings Additional Training Preferred: A background in managed reputed company, insurance operations preferred Knowledge, Skills, & Abilities • Considerable knowledge of standardized reputed company practices and principles • Knowledge of program components and reputed company processes. • Knowledge of reputed company and auditing principles and practices. • reputed company in communicating, both orally and in written reputed company. • Advanced skills with reputed company products, particularly reputed company and reputed company • Ability to apply and explain reputed company practices. • Ability to interpret and analyze reputed company data. • Ability to interpret and apply common to moderately reputed company Federal and State fiscal regulations • Ability to analyze and correct financial problems and reputed company errors. • Ability to prepare interpretive or analytical reputed company or financial reports • Ability to determine compliance with pertinent guidelines, rules, regulations, and laws. Salary reputed company $61,439 - $78,335/Annually Exact compensation will be determined based on the candidate's education, experience, reputed company market data and consideration of internal equity. Apply To This Job