Managed Care Analyst I

Sarasota Memorial Health Care System; Sarasota (FL); Presencial; USD 50.000 - 75.000; Tempo integral

Resumo da vaga

Sarasota Memorial Health Care System is seeking a detail oriented professional in Patient Financial Services to oversee the collection and reconciliation of underpayments on managed care contracts. The role maintains a current status log, updates the training manual, and delivers weekly and monthly collection reports to the Manager.

The ideal candidate has a minimum of five years in healthcare collections; a Bachelor's degree can substitute for experience.

Qualificações

• Minimum of five (5) years of collections or healthcare-related experience.
• A bachelor's degree can substitute for the required work experience.

Responsabilidades

• Responsible for the collection and reconciliation of underpayments on managed care contracts.
• Maintains a log of the current status of underpayments collected.
• Provides weekly and monthly reports of collections to the Manager.
• Develops relationships with insurance carriers to address underpayments.

Conhecimentos

Healthcare collections

Accounts receivable

Contract management

Analytical skills

Formação

HS Diploma or GED

Associate degree (preferred)

Ferramentas

Excel

PMMC (or similar system)

Descrição da vaga

Department

Patient Financial Services

Job Summary

Responsible for the collection and reconciliation of underpayments on managed care contracts. Maintains a log of the current status of underpayments collected. Maintains and continually updates the department training manual. Provides a weekly and a monthly report of collections to the Manager. Responsible for completion of projects that are pro‑active and focused on problem areas and high cost services to ensure maximum contractual reimbursement. Responsible for understanding the reimbursement methods by contract and knowledge of PMMC for contract management reporting. Responsible for developing a strong relationship with insurance carriers in order to address multiple underpayments by a given payer.

Required Qualifications

• Require a minimum of five (5) years of collections or healthcare‑related experience within a healthcare setting. A bachelor's degree can substitute for the required work experience.

Preferred Qualifications

• Prefer Certified Patient Account Technician (CPAT) or Certified Revenue Cycle Specialist (CRCS).
• Prefer demonstrated analytic skills.
• Prefer demonstrated computer skills in spreadsheet database, word processing, PMMC and any other applications.
• Prefer strong interpersonal skills, including the ability to handle difficult situation in a diplomatic manner.
• Prefer ability to type a minimum of forty‑five (45) words per minute.

Mandatory Education

HS EQ: High School Diploma, GED or Certificate

Preferred Education

AD: Associate's Degree

Employment Screening Requirements

As part of Sarasota Memorial Health Care System's commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/