Remote Payment Policy Research Analyst

Sentara Health; Indiana; Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical Insurance

401k with employer match

Paid time off

Tuition assistance

Job summary

Sentara Health is seeking a Payment Policy Research Analyst in Virginia Beach, VA to identify, develop, and present cost-saving opportunities within payment policies for Sentara Health Plan. You will analyze data insights, leverage policy knowledge, and collaborate with subject matter experts to drive growth and savings deployment.

The role requires CPC certification within six months, 3 years of health plan or medical coding experience, and a BS/BA or higher degree in healthcare.

Qualifications

• 3 years health plan experience or 3 years medical coding required.
• CPC certification required within 6 months of hire.
• BS/BA or advanced degree in health care or medical field preferred.
• 3 years health plan claim auditing or appeals preferred.

Responsibilities

• Research and assess internal payment policies to identify cost savings opportunities.
• Determine strategies to achieve savings through policy development or enhancement, authorization criteria and process changes.
• Participate in analytical, investigative or fact-finding work to support opportunity development.
• Establish relationships with stakeholders to define, align and deliver payment initiatives and policy development.
• Influence leadership to adopt new ideas, approaches and/or products.

Education

High School Diploma

Bachelor degree preferred

Tools

Excel

PowerPoint

Outlook

Job description

Sentara Health is seeking a Payment Policy Research Analyst in Virginia Beach, VA to identify, develop, and present cost-saving opportunities within payment policies for Sentara Health Plan. You will analyze data insights, leverage policy knowledge, and collaborate with subject matter experts to drive growth and savings deployment.

The role requires CPC certification within six months, 3 years of health plan or medical coding experience, and a BS/BA or higher degree in healthcare.