• Analyst Reimbursement Managed Care - Remote

    AdventHealth (Altamonte Springs, FL)


    Our promise to you:

    Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better.

    All the benefits and perks you need for you and your family:

    + Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

    + Paid Time Off from Day One

    + 403-B Retirement Plan

    + 4 Weeks 100% Paid Parental Leave

    + Career Development

    + Whole Person Well-being Resources

    + Mental Health Resources and Support

    + Pet Benefits

    Schedule:

    Full time

    Shift:

    Day (United States of America)

    Address:

    900 HOPE WAY

    City:

    ALTAMONTE SPRINGS

    State:

    Florida

    Postal Code:

    32714

    Job Description:

    Demonstrated strong analytical reasoning, critical thinking, judgment, and problem-solving skills in order to independently assess, interpret, and address complex issues in a continually changing environment Demonstrated strong computer software skills including Microsoft Office applications, with a proficiency in Microsoft Excel and the ability to work with and manipulate data within Reports, Formulas, Charts, and Pivot Tables Submits credentialing reports accurately and timely. Confirms provider information on credentialing applications and reports. Enters effective date and provider number information from payers into relevant systems. Reviews and resolves claim denials related to credentialing and enrollment status. Identifies and analyzes payment variances for professional fee contracts and government payers. Reviews reports to determine true variances based on reimbursement guidelines and contracted fee schedules. Liaises with payers to address issues and ensure accurate processing. Works closely with Managed Care contract administration to ensure accurate provider profiles. Maintains knowledge of current rules and regulations of Commercial and Government programs. Aggregates and categorizes variance types for management review. Serves as a resource for payment variance identification and education. Coordinates with billing support teams on identified payment variances and credentialing denials. Other duties as assigned.

    The expertise and experiences you’ll need to succeed:

    QUALIFICATION REQUIREMENTS:

    Bachelor's, High School Grad or Equiv (Required)

    Pay Range:

    $45,196.93 - $84,071.39

     

    _This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances._

     

    **Category:** Revenue Cycle & Managed Care

    **Organization:** AdventHealth Corporate

    **Schedule:** Full time

    **Shift:** Day

    **Req ID:** 150660940