CareCentrix

Senior Analyst - Provider Service

US-CT-Hartford
Job ID
2017-4867

Overview

This Sr. Analyst role will report to the Director of the Provider Services team who is responsible for outreaching to and educating newly contracted providers on CareCentrix policies and procedures.  This Sr. Analyst role may also work to complete research and resolve provider service issues related to claim payments to improve their outstanding A/R and to provide consistent payment patterns. This activity includes researching claim rejections and denials, portal connectivity issues, educate and communicate policy and process changes. Sr. Analyst is responsible to identify trends, root causes, and develops action plans to resolve root causes. Provides education to billing agencies and provider offices to ensure appropriate billing. Assumes an active role in developing strong provider relationships, evaluating provider performance, conducting financial evaluations, formulating tactical plans, and leading special projects. The quality and execution of the Sr. Analysts’ work is critical to the success of the Provider Services.


Sr. Analysts play a crucial role within the team, gathering, analyzing and synthesizing information. They are responsible to identify critical performance trends and undertake rigorous analyses that improve CareCentrix’s financial performance. The Analyst role is responsible for improving the overall relationship with the provider. They act as account managers to proactively identify trends and patterns to ensure the overall provider experience and satisfaction improves.

 

 

Responsibilities

  • Welcomes newly contracted providers and invites them to onboarding orientation sessions.
  • Conducts onboarding orientation sessions through virtual and on-site sessions.

Conducts claims research to identify patterns and trends that cause a disruption to timely and accurate payment of claims.

  • Performs analyses to assess provider trends, process gaps and opportunities and to improve the overall provider experience.
    • Performing rigorous tactical and financial analysis to pinpoint appropriate and practical recommendations relative to the provider network
    • Proactively develops and manages provider relationships.
    • Seeks to improve the provider experience through effective research and resolution to provider issues and concerns.
    • Participates actively in projects and tactical initiatives led by the Provider Service department.
    • Collaborates and works well within both the Provider Service team and across other departments.
    • Collaborating with team members to derive trends, conclusions and recommendations based on the data and analyses.
    • Manages multiple tasks and projects, is detail oriented, responsive, and demonstrates independent thought and critical thinking.
    • Provides Provider Education/Training on Policy and Process changes and other communications as necessary.
    • Responsible for researching Portal connectivity and access issues. Handles portal password resets as needed.
    • Researches, resolves and tracks provider complaints related to Authorization issues.
    • Facilitates and participates in Provider Town Hall meetings as needed.
    • Participates in special projects and performs other duties as assigned.

Qualifications

Bachelor’s Degree preferred, with a business or IT concentration preferred. Health Insurance industry experience required with a minimum of three years of experience in claims, medical coding, analytics, provider training (specifically skilled nursing facilities and inpatient rehabilitation facilities), or provider service operations. Knowledge of claim payment processes and systems is preferred. Medical coding certification preferred. Strong written and verbal communication skills with experience interacting with Providers and/or Billing Agencies.

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed