Senior Managed Care Analyst - Full Time

Jupiter Health Outpatient Services Inc

Palm Beach County, US
Minimum five years payer contracting experience
Knowledge of medicare allowable rate calculations
Familiarity with fee schedules and charge masters
The Senior Managed Care Analyst supports the Managed Care Department by reviewing contracts and modeling payer performance metrics

Job Summary

  • The Senior Managed Care Analyst supports the Managed Care Department by reviewing contracts and modeling payer performance metrics.
  • This role requires deep knowledge of Medicare and Medicaid regulations, including DRGs, APC rates, and payment modifiers.
  • The position involves collaborating with finance and revenue cycle teams to evaluate denials, audits, and appeals trends.

Matching Summary

The Senior Managed Care Analyst supports the Managed Care Department by reviewing contracts and modeling payer performance metrics.

Skills & Requirements

Must-have

  • Minimum five years Payer Contracting experience
  • Knowledge of Medicare Allowable rate calculations
  • Familiarity with fee schedules and charge masters
  • Understanding of billing and denial processes
  • Proficiency in Microsoft Office and Excel

Nice-to-have

  • Epic experience preferred
  • Masters Degree in relevant field
  • Ability to multitask in fast-paced environment
  • Strong mathematical and analytical skills
  • Experience with pricing transparency tools

Key Requirements

  • Bachelors Degree in Accounting or Finance required
  • Minimum five years of Payer Contracting or Revenue Cycle experience
  • Knowledge of ICD-10 and CPT/HCPCS coding
  • Maintenance of required professional licensing and/or certification(s)

Work Rights

Not specified

Tailored Resume

Cover Letter