Managed Care Administrative Analyst

Bon Secours; Taguig; Hybride; PHP 420 000 - 540 000; Plein temps

Avantages offerts par ce poste

Comprehensive HMO

Résumé du poste

Bon Secours Mercy Health in Manila seeks an Administrative Analyst for Managed Care & Reimbursement to support enrollment, credentialing, and re-credentialing for hospitals and affiliated entities with commercial and government payers. This role ensures compliant billing and timely reimbursement by maintaining provider data, managing payer applications, and resolving enrollment issues.

Based in Global Business Services – Manila, the analyst collaborates with stakeholders and payer organizations

Qualifications

• 1 year experience in healthcare reimbursement environment.
• Preferred: 3+ years in managed care/reimbursement.

Responsabilités

• Prepare and track credentialing applications for enrollment.
• Monitor credentialing status and expiration dates.
• Verify documentation and collect signatures for enrollment.
• Maintain enrollment data across credentialing systems.
• Contact payers to resolve enrollment issues.

Connaissances

Multitasking

Critical thinking

Confidentiality

Time management

Communication skills

Database basics

Formation

Associate degree

Bachelor's degree

Outils

Word

Excel

Access

PowerPoint

Adobe PDF

Description du poste

Thank you for considering a career at Bon Secours Mercy Health!

Scheduled Weekly Hours:

40

Work Shift:

9pm to 6am (Philippines)

Job Summary:

The Managed Care & Reimbursement Administrative Analyst supports Bon Secours Mercy Health’s Reimbursement team by ensuring timely and accurate enrollment, credentialing and re-credentialing for BSMH’s hospitals and affiliated entities with commercial and government payers. This role is essential to enabling compliant billing and uninterrupted reimbursement by maintaining accurate provider data, managing payer applications, and resolving enrollment-related issues. As a member of the Reimbursement team within Global Business Services – Manila, this position serves as a key liaison between internal stakeholders and payer organizations, ensuring compliance with regulatory requirements and payer-specific credentialing standards.

Essential Functions:

• Prepare, submit, and track initial and re-credentialing applications for new and existing entities to ensure timely enrollment with commercial and government payers.
• Monitor credentialing and enrollment status, including expiration dates, to prevent gaps in payer participation and minimize revenue disruption.
• Partner with stakeholders to collect and verify required documentation, signatures, and information for enrollment submissions.
• Maintain enrollment data within credentialing software, payer portals, and databases, ensuring information integrity and accuracy.
• Serve as the primary point of contact for payers to resolve enrollment issues, clarify requirements, and expedite application processing.
• Work closely with revenue cycle teams to identify and address claim denials or delays caused by credentialing or enrollment gaps.
• Ensure all credentialing and enrollment activities comply with federal, state, and payer-specific regulations and health system policies.
• Regularly monitor payer portals, correspondence, and notifications for status updates and take prompt action to maintain active participation.
• Generate reports and summaries for leadership to track enrollment performance, identify trends, and highlight opportunities for improvement.
• Collaborate with managed care and reimbursement leadership to streamline and enhance credentialing and enrollment processes for greater efficiency and accuracy.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Education:

• Associate’s degree in business, Health Administration, or another discipline that provides applicable experience (required)
• Bachelor’s degree in business, Health Administration, or another discipline that provides applicable experience (preferred)

Required Licensing & Certifications:

N/A

Experience:

• 1 year experience in healthcare environment dealing with reimbursement (required)
• Prefer managed care/reimbursement experience of at least three (3) (preferred)

Skills & Abilities:

• Possesses the ability to handle multiple tasks simultaneously and prioritize work according to departmental needs while coping with deadlines and stress.
• Demonstrate strong critical thinking and problem-solving skills, allowing them to work independently and adapt to change while collaborating with a variety of personalities.
• Ability to ensure the confidentiality and rights of patients, as well as the confidentiality of sensitive hospital and departmental documents.
• Ensure accurate entry and communication of information and understand instructions effectively.
• Strong organizational skills and effective time management abilities.
• Excellent critical thinking skills and maintain effective public and co-worker harmony, demonstrating outstanding interpersonal skills.
• Strong communication—both written and oral—and presentation skills.
• Proficient in database management and PC applications, including Word, Excel, Access, PowerPoint, and Adobe PDF.

Training:

N/A

As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What we offer

• Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
• One-time Work From Home allowance, connectivity allowance, wellness allowance and role-specific allowances
• Paid vacation and sick leave
• Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
• Flexible working model with hybrid, onsite or virtual arrangements (based on role and business need)
• Mission-driven culture events, community outreach and service opportunities
• Learning and development programs, mentorship and clear career growth pathways
• Modern, collaborative office spaces and regular engagement and culture-building activities

Benefits may vary based on employment terms and role.

Department:

Revenue Management - Managed Care - BSMH Global Business Systems

It is our policy to comply with all applicable Philippine labor laws and regulations and to uphold equal employment opportunity in all aspects of recruitment and employment.

All applicants will be considered for employment based on merit, qualifications, and business requirements, without regard to race, color, ethnicity, religion, sex, sexual orientation, gender identity or expression, civil status, age, disability, genetic information, nationality, or any other status protected under Philippine law.

We are committed to providing an inclusive workplace free from unlawful discrimination and harassment.

If you are a person with a disability and require reasonable accommodation as part of the application or selection process, please contact the Talent Acquisition Team at @bsmhealth.org. We will work with you to provide appropriate assistance in accordance with applicable laws and company policy.