Claim Analytics Manager | Permanent WFH

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Requirements:

• Bachelor's degree in a related field of study.
• Minimum of 7 years of occupational experience in the financial side of the healthcare sector with an emphasis on Revenue Cycle, analytics, custom report writing and data management.
• Proficiency in correspondence, presentations and other communication methods.
• Ability to partner with various stakeholders and facilitate collaboration therein.
• Demonstrating and practicing a sense of urgency with work responsibilities.
• A preference for proficiencies in data science (including SQL, Alterix, PowerBI) to facilitate data extraction.

Responsibilities:

• Establish a regular protocol to identify claims that have achieved a zero balance and isolate the payments, adjustments and other essential components of the transaction history for the purpose of understanding those claim behaviors.
• Summarize the behavior of those zero claims by major payor group, specific insurance plan and also to the group level within insurance plans as needed.
• Serve as a subject matter expert on custom report writing, data warehouse and data lake functions within and connected to Revenue Cycle.
• Provide custom report writing as needed to monitor and quantify transactional activity associated with Specialty Vendors who also serve Revenue Cycle needs.
• Provide direct support and feedback to Revenue Cycle leaders where data needs exist and work with the Director Payor Relations and Vice President Revenue Cycle to prioritize those requests.
• Obtain an advanced knowledge or core Revenue Cycle platforms to further enhance information and outcomes.
• Drive excellence by assuring the highest quality of output reporting within the Revenue Cycle and other areas called upon for support.
• Attend various internal meetings to gain knowledge of Revenue Cycle operational needs and challenges.
• Offer feedback, guidance and recommendations into areas of need based upon knowledge and/or experience.
• Assist internal leadership within Revenue Cycle by interacting with other software vendors as needed.
• Publish a monthly internal report on activities for executive leadership.
• Assuring, documenting and returning value to the organization in excess of the compensation package.