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