Operations Analyst Managed Care Hybrid
Operations Analyst Managed Care Hybrid
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
The Operations Analyst reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.
Responsibilities:
- Works with multiple operations departments including Revenue Cycle Information Systems and Access to implement the operations of the managed care government and special project contracts as well as any major administrative payer requirements that have a material financial impact.
- Participates in regular meetings with the vendor in maintaining and updating the insurance on demand tool. Continuously provides feedback and recommendations for a better end user experience that provides an efficiency and ease of navigating the tool.
- Collaborates with Sr. Operations Analyst to understand and load contract logic within the Epic patient accounting system to calculate expected reimbursement accurately on billed charges which will directly affect Accounting/Finance tasks.
- Ensures assigned payer contracts are loaded correctly into the NM system and in a timely matter and approves the testing of the reimbursement functions.
- Responsible for supporting various departments through the escalation of tickets through the Service Now portal based on the appropriately assigned payor and/or category.
- Works with Sr. Operations Analyst to create reimbursement tools with all managed care contracted rate schedules by region for the patient accounting teams to utilize when following up on managed care accounts.
- Researches and works out resolution on contract load issues resulting in discrepancy of payment.
- Performs special projects as duties as assigned by the Manager and Director Managed Care.
Qualifications :
Required:
- Bachelors degree in Business Administration Healthcare Management Communications or related field preferred or equivalent experience
- Minimum 2 years of relevant experience in a managed care organization consulting firm hospital system/hospital
- Excellent written and oral communications skills are necessary
- Strong organizations skills and experience with managed care contracting is essential
- Knowledgeable in A/R Claims Management or Patient Accounting functions
- Proficiency in data analysis
Preferred:
- Five or more years of relevant experience in a managed care organization consulting firm hospital system/hospital.
Additional Information :
Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status.
Remote Work :
No
Employment Type :
Fulltime
Employment Type
Full-time
