Managed Care Financial Services Assistant

Penn Medicine; Philadelphia (Philadelphia County); Hybrid; USD 32,000 - 40,000; Full time

Job summary

Penn Medicine is seeking a detail-oriented professional to support reimbursement and financial analysis across managed care contracts. The role involves verifying account values, reviewing insurance payments versus contracted amounts, and collaborating with the Office of Hospital Reimbursement to support denial tracking and reporting.

The position reports to the Director of Operations Reimbursement and Managed Care Analysis and offers remote work with initial in-person training at Philadelphia,

Qualifications

• High school diploma or GED required.
• At least 1 year of hospital or physician managed care contract management or billing operations experience required.
• Bachelor's degree may substitute for years of experience.
• Bachelor of Arts or Science preferred.
• Basic understanding of medical billing processes and revenue cycle management preferred.

Responsibilities

• Work closely with Managed Care department and the Contract Management Administrator to ensure contract terms are identified and maintained in the contract management system.
• Assist the Manager and the Sr. Analyst in development and maintenance of fee schedules and audits.
• Assist department in reviewing payment accuracy and patient account review, as needed.
• Support the Senior Financial Analyst with hospital revenue modeling assuring accuracy and attention to detail.
• Work closely with appropriate departments on denials tracking and reporting.
• Fulfill monthly/yearly reporting needs of for Denial Software.
• Support UPHS Managed Care and Corporate Finance in contract analysis and revenue forecasting.
• Adheres to monthly closing schedule for all reporting requirements.

Education

H.S. Diploma/GED

1+ years Hospital and/or physician managed care contract management or hospital and/or physician billing operations experience

Bachelor's degree may substitute for years of experience

Bachelor of Arts or Science (Preferred)

Basic understanding of medical billing process flows and revenue cycle management techniques (Preferred)

Job description

Description

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

• Entity: Corporate
• Department: Phys Reimb and Fin Analysis
• Location: Remote with initial in person training based out of 3535 Market St. Philadelphia, PA
• Hours: 8hr Days

Summary

Under the leadership of the Director of Operations Reimbursement and Managed Care Analysis and the Manager of the Office of Hospital Reimbursement, this position supports the maintenance of the Hospital Contract Manager /Modeler software. This includes verification of account values and review of insurance payments as compared to the contracted amounts. In addition, the Managed Care–Financial Services Assistant will work closely with the Manager of the Office of Hospital Reimbursement in Denial Tracking software and fulfilling general analysis and reporting needs.

Responsibilities

• Work closely with Managed Care department and the Contract Management Administrator to ensure that contract terms are properly identified and maintained in the contract management system.
• Assist the Manager and the Sr. Analyst in development and maintenance of fee schedules and audits.
• Assist department in reviewing payment accuracy and patient account review, as needed.
• Support the Senior Financial Analyst with hospital revenue modeling assuring accuracy and attention to detail.
• Work closely with appropriate departments on denials tracking and reporting.
• Fulfill monthly/yearly reporting needs of for Denial Software.
• Support UPHS Managed Care and Corporate Finance in contract analysis and revenue forecasting.
• Adheres to monthly closing schedule for all reporting requirements.

Education or Equivalent Experience

• H.S. Diploma/GED (Required)
• And 1+ years Hospital and/or physician managed care contract management or hospital and/or physician billing operations experience. (Required)
• Bachelor's degree may substitute for years of experience.
• Bachelor of Arts or Science (Preferred)
• Basic understanding of medical billing process flows and revenue cycle management techniques. (Preferred)

Live Your Life's Work

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.