Senior Financial Analyst JobLouisville, KY
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Why You'll Love This Job
Commonwealth Pain & Spine is a pain management network dedicated to improving the lives of our patients by treating their pain with the utmost respect and providing them with the most innovative, safe, responsible, and clinically proven pain relief possible.
Our team of best-in-class physicians, administrators, and staff empathizes with the needs of our patients. We recognize that their pain is exhausting and debilitating and limits their quality of life. Relief from chronic pain is achievable in various degrees through our intelligent and multimodal team-based approach. Our entire team is committed to providing levels of patient satisfaction and overall clinical outcomes that far exceed the expectations of the medical community, referring physicians, and our customers.
The Analyst is responsible for developing proactive solutions for managed care contracts. Serves as a lead and data expert for implementation, dashboards pertaining to managed care contracting and performance outcome success. This position will update the dashboard, validate data, and forecast performance reporting and functionality. This position represents both internal and external progress, incentives and initiatives in their area as well as educating and training internal and external stakeholders on the organization’s system wide initiatives.
Benefits:
· Competitive compensation
· License and DEA Reimbursement
· Annual Education/CME reimbursement
· Comprehensive Health/Vision/Dental insurance options
· Great PTO plan PLUS Paid Holidays
· 401k and matching available
Our team of best-in-class physicians, administrators, and staff empathizes with the needs of our patients. We recognize that their pain is exhausting and debilitating and limits their quality of life. Relief from chronic pain is achievable in various degrees through our intelligent and multimodal team-based approach. Our entire team is committed to providing levels of patient satisfaction and overall clinical outcomes that far exceed the expectations of the medical community, referring physicians, and our customers.
The Analyst is responsible for developing proactive solutions for managed care contracts. Serves as a lead and data expert for implementation, dashboards pertaining to managed care contracting and performance outcome success. This position will update the dashboard, validate data, and forecast performance reporting and functionality. This position represents both internal and external progress, incentives and initiatives in their area as well as educating and training internal and external stakeholders on the organization’s system wide initiatives.
Benefits:
· Competitive compensation
· License and DEA Reimbursement
· Annual Education/CME reimbursement
· Comprehensive Health/Vision/Dental insurance options
· Great PTO plan PLUS Paid Holidays
· 401k and matching available
Responsibilities
· Assist in tracking and trending contract issues.
· Possess extensive knowledge of payor contracts and policies.
· Identify variances, trends, and contracting omissions.
· Create and maintain detailed reports and review with Director of Contracting
· Assist in assessing and analyzing current payor contracts for areas of improvement and contract maximization during contract negotiation.
· Review and present findings, solutions, and recommendations Director of Contracting and Credentialing.
· Memorize and comprehend contract terms, renewal and end dates, or other time-sensitive information.
· Analyze coding, reimbursement hierarchy, interpret verbiage and contract language intent.
· Research and variance recovery, global trends of variances, and contact payors to recover underpayments.
· Maintain systems and track variance statistics.
· Analyze relevant data to provide reports, which includes determining the impact of adjustments to managed care reimbursement terms and/or contract compliance, along with rate modeling necessary for contract negotiations.
· Collaborate with Payment Specialist team to determine accuracy of insurance payments.
· Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct payments.
· Manages and maintains charge master.
· Performs other duties, as assigned.
· All other duties assigned including duties performed for affiliates, assigns, lessees, contractors or other third parties
· Possess extensive knowledge of payor contracts and policies.
· Identify variances, trends, and contracting omissions.
· Create and maintain detailed reports and review with Director of Contracting
· Assist in assessing and analyzing current payor contracts for areas of improvement and contract maximization during contract negotiation.
· Review and present findings, solutions, and recommendations Director of Contracting and Credentialing.
· Memorize and comprehend contract terms, renewal and end dates, or other time-sensitive information.
· Analyze coding, reimbursement hierarchy, interpret verbiage and contract language intent.
· Research and variance recovery, global trends of variances, and contact payors to recover underpayments.
· Maintain systems and track variance statistics.
· Analyze relevant data to provide reports, which includes determining the impact of adjustments to managed care reimbursement terms and/or contract compliance, along with rate modeling necessary for contract negotiations.
· Collaborate with Payment Specialist team to determine accuracy of insurance payments.
· Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct payments.
· Manages and maintains charge master.
· Performs other duties, as assigned.
· All other duties assigned including duties performed for affiliates, assigns, lessees, contractors or other third parties
Skills & Qualifications
· Strong organizational skills and demonstrated ability to work independently and prioritize responsibilities.
· Adheres to all patient confidentiality policies and carries out all tasks in a pleasant and respectful manner.
· Knowledge of industry-specific terminology, billing and collections principles and best practices with complete understanding of relevant laws, rules, and regulations
· This position requires the use of critical thinking skills to interpret complex managed care contracts to maintain the Contract Management System and ensure estimated reimbursement is calculating maximum and correct reimbursement.
Education and Experience:
· Bachelor’s degree preferred.
· 3-5 years of Managed Care or contracting experience required.
· Knowledge of CPT coding
· If required to travel for company related purposes:
· Active, valid driver 's license
· State minimum coverage vehicle insurance
· Must be able to pass driving history/motor vehicle check upon hire and maintain an acceptable record thereafter
· Maintain status as an “approved driver” through the HR department, including submitting required documentation before expiration.
Physical Requirements:
The physical demands of this position will include sitting and standing with occasional light to medium lifting. Ability to help lift patients and transport in wheelchair from clinic to parking lot. An employee must meet these requirements to successfully perform the essential duties of this job. Reasonable accommodation will be made in accordance with ADA rules and regulations.
Commonwealth Pain and Spine is an Equal Employment Opportunity Employer!
Apply Now
· Adheres to all patient confidentiality policies and carries out all tasks in a pleasant and respectful manner.
· Knowledge of industry-specific terminology, billing and collections principles and best practices with complete understanding of relevant laws, rules, and regulations
· This position requires the use of critical thinking skills to interpret complex managed care contracts to maintain the Contract Management System and ensure estimated reimbursement is calculating maximum and correct reimbursement.
Education and Experience:
· Bachelor’s degree preferred.
· 3-5 years of Managed Care or contracting experience required.
· Knowledge of CPT coding
· If required to travel for company related purposes:
· Active, valid driver 's license
· State minimum coverage vehicle insurance
· Must be able to pass driving history/motor vehicle check upon hire and maintain an acceptable record thereafter
· Maintain status as an “approved driver” through the HR department, including submitting required documentation before expiration.
Physical Requirements:
The physical demands of this position will include sitting and standing with occasional light to medium lifting. Ability to help lift patients and transport in wheelchair from clinic to parking lot. An employee must meet these requirements to successfully perform the essential duties of this job. Reasonable accommodation will be made in accordance with ADA rules and regulations.
Commonwealth Pain and Spine is an Equal Employment Opportunity Employer!