Managed Care Revenue Optimization Analyst - Ft - Days - Mss - Hybrid Eligible
Memorial Healthcare System
Miramar, Florida, USA
Hybrid
Analyze denials and short payments
Obtain payment per contract terms
Reconcile and update business systems
Memorial Healthcare System is seeking a Managed Care Revenue Optimization Analyst for a hybrid role in Miramar, Florida. The analyst will review and analyze insurance denials and payment issues to ensure compliance with billing guidelines and maximize revenue recovery
Job Summary
Reviews and analyzes denials and short payments received from insurance plans to determine best plan for resolution.
Interacts directly with Department Clinical Team as needed to obtain pertinent clinical facts needed to support medical necessity of services provided.
Responsible for identifying and reporting to Management payment and denial trends for assigned payors.
Matching Summary
Match Score: 85
Memorial Healthcare System is seeking a Managed Care Revenue Optimization Analyst for a hybrid role in Miramar, Florida. The analyst will review and analyze insurance denials and payment issues to ensure compliance with billing guidelines and maximize revenue recovery.
Skills & Requirements
Must-have
analyze denials and short payments
obtain payment per contract terms
reconcile and update business systems
identify payment and denial trends
Nice-to-have
critical thinking and effective communication
independent decision making
formulate and write formal business communications
Key Requirements
High School Diploma or Equivalent
Two (2) years experience in hospital/physician business office, managed care collections or managed care claims environment