Managed Care Analyst I

Sarasota Memorial Health Care System; Sarasota (FL); On-site; USD 50,000 - 75,000; Full time

Job summary

A leading healthcare provider is seeking a Managed Care Analyst I responsible for collecting and reconciling underpayments on healthcare contracts. The role involves managing projects related to high-cost services and maintaining strong relationships with insurance providers. Candidates should possess significant healthcare collections experience and strong analytical skills.

Qualifications

• Minimum 5 years of healthcare collections experience or related healthcare experience; Bachelor's degree can substitute.
• CPAT or CRCS certification preferred.
• Typing speed of at least 45 words per minute.

Responsibilities

• Collecting and reconciling underpayments on managed care contracts.
• Updating training manuals and reporting collections weekly and monthly.
• Building relationships with insurance carriers to resolve underpayments.

Skills

Analytic skills

Computer skills

Interpersonal skills

Education

High School Diploma, GED, or Certificate

Associate's Degree

Job description

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Job Summary

Responsible for the collection and reconciliation of underpayments on managed care contracts. Maintains a log of the current status of underpayments collected. Updates the department training manual and provides weekly and monthly reports of collections to the Manager. Focuses on projects that address problem areas and high-cost services to maximize contractual reimbursement. Understands reimbursement methods by contract and has knowledge of PMMC for contract management reporting. Develops strong relationships with insurance carriers to address multiple underpayments.

Job Description

Department: Patient Financial Services

Responsibilities include:

• Collecting and reconciling underpayments on managed care contracts
• Maintaining a log of collection statuses
• Updating training manuals
• Reporting collections weekly and monthly
• Managing projects focused on problem areas and high-cost services
• Understanding reimbursement methods and contract management reporting
• Building relationships with insurance carriers to resolve underpayments

Qualifications

Required:

• Minimum of five (5) years of healthcare collections experience or related healthcare experience. A bachelor’s degree can substitute for experience.

Preferred:

• CPAT or CRCS certification
• Analytic skills
• Computer skills including spreadsheets, databases, PMMC, and other applications
• Strong interpersonal skills and diplomacy
• Typing speed of at least 45 words per minute

Education

Mandatory: High School Diploma, GED, or Certificate

Preferred: Associate's Degree

Licenses and Certifications

Preferred licenses and certifications are not specified.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider
• Industry: Hospitals and Healthcare