Payor Contracting Analyst

Remote position Benefits :

* Competitive Health & Welfare Benefits * HSA with qualifying HDHP plans with company match * 401k plan after 6 months of service with company match (Part-time employees included) * Employee Assistance Program that is available 24/7 to provide support * Employee Appreciation Days * Employee Wellness Events

Minimum Qualifications:

* Minimum of three years of experience working in an analytic role in a healthcare environment (payor or provider) with an in-depth knowledge of physician reimbursement methodologies. * Intermediate to advanced-level MS Excel skills (pivot tables, vlookups, conditional formulas). * Experience using relational databases.

* Bachelor's Degree in Finance or Healthcare Administration preferred.

Essential Functions

* Demonstrate thorough knowledge of CMS regulations and reimbursement methodologies relevant to professional claims. * Familiarity with value-based care payment models and industry trends. * Familiarity with managed care products and services, medical cost trend analysis, including analysis of physician contracts, utilization, and costs. * Familiar with a variety of concepts, practices, and procedures in the field of managed care and practice management. * Possesses strong organizational skills and careful attention to detail. * Must be able to problem-solve and come forward with recommendations. * Must be able to stay on task with minimal supervision. * Excellent critical thinking, troubleshooting, and analytical skills.

KNOWLEDGE

* Knowledge of physician reimbursement. * Knowledge of provider billing practices. * Knowledge of CPT codes, modifier rules, CMS payment policies.

SKILLS

* Skill in effective data collection and analysis. * Skill in designing analyses and appropriate reports. * High-level attention to detail, accuracy, and organization skills.

ABILITIES

* Strong ability to prepared and understand functional and technical specifications. * Ability to analyze problems and interpret information and prioritize and reprioritize, as necessary. * Ability to work independently, and as part of a team. * Ability to multi-task, manages multiple projects, and meets tight deadlines.