Managed Care Revenue Optimization Analyst - FT - Days - MSS - Hybrid Eligible
Core
Reviews and analyzes insurance denials and short payments to determine resolution plans and obtain payment in accordance with contracts and laws.
Role type
Managed Care Revenue Optimization Analyst
Builds
Collections and payment recovery for hospital/physician services
Domain
Healthcare administration / Managed care billing
Deliverable
client delivery
Required skills
Managed care claims processing, Billing and coding compliance, Federal and state regulations knowledge, Data reconciliation, Formal business communication writing, Trend analysis
Preferred skills
Clinical team interaction, Microsoft Excel intermediate proficiency
Responsibilities
Review and analyze managed care balances for denials or short payments, Compile detailed written appeal documents, Track outcomes of payment requests, Reconcile and update business systems with findings, Identify and report payment and denial trends, Interact with clinical teams to obtain facts for medical necessity
Seniority
Individual Contributor, 2+ years experience