AR Specialist 1
Savista
Invision
Physician Managed Care Analyst
Tenet Healthcare
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteSalary
💰 $17 - $26 per hour
Job Level
Mid-LevelSenior
About the role
- Perform analysis of managed care contracts and agreements
- Research specifics of doing business with Managed Care clients and payors
- Serve as primary analyst of managed care information and health plan specific policies to internal departments
- Conduct research to assist development of policies, procedures, manuals, and internal documentation
- Maintain fee schedule and contract database by collecting client contracts, loading terms and preparing fee schedules
- Analyze payment data related to client managed care contracts to ensure payor compliance and communicate results to leader
- Coordinate claim reprocessing projects when necessary
- Research managed care contracts for negotiation purposes when necessary
- Manage multiple projects and timelines
Requirements
- 5 years managed care experience within a managed care organization, physician, IPA or billing environment with experience in revenue cycle management and managed care contracting related fields
- Comprehensive understanding of reimbursement methodologies, fee schedules, HCPCS, CPT4, ICD9, CCI edits, and industry standard physician billing and claims adjudication practices
- Knowledge of EPIC and IDX billing systems preferred
- High School Diploma/GED (StudyLevel: High School Diploma/GED)
- Ability to travel
- Must be able to work in sitting position, use computer and answer telephone
- Ability to walk through hospital-based departments across broad campus settings, including Emergency Department environments
- Must obtain and provide confirmation of required vaccinations and screenings as applicable (may include COVID-19 and influenza)
