Managed Care Analyst I

Department

Patient Financial Services

Job Summary

Responsible for the collection and reconciliation of underpayments on managed care contracts. Maintains a log of the current status of underpayments collected. Maintains and continually updates the department training manual. Provides a weekly and a monthly report of collections to the Manager. Responsible for completion of projects that are pro-active and focused on problem areas and high cost services to ensure maximum contractual reimbursement. Responsible for understanding the reimbursement methods by contract and knowledge of PMMC for contract management reporting. Responsible for developing a strong relationship with insurance carriers in order to address multiple underpayments by a given payer.

Required Qualifications

• Require a minimum of five (5) years of collections or healthcare-related experience within a healthcare setting. A bachelor's degree can substitute for the required work experience.

Preferred Qualifications

• Prefer Certified Patient Account Technician (CPAT) or Certified Revenue Cycle Specialist (CRCS).
• Prefer demonstrated analytic skills.
• Prefer demonstrated computer skills in spreadsheet database, word processing, PMMC and any other applications.
• Prefer strong interpersonal skills, including the ability to handle difficult situation in a diplomatic manner.
• Prefer ability to type a minimum of forty-five (45) words per minute.

Mandatory Education

HS EQ: High School Diploma, GED or Certificate

Preferred Education

AD: Associate's Degree

Required License and Certs

Preferred License and Certs

Employment Screening Requirements

As part of Sarasota Memorial Health Care System's commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/