Join Martin Luther King, Jr. Community Hospital as a Revenue and Managed Care Analyst, where you'll play a crucial role in optimizing managed care contracts and enhancing revenue cycle operations to support underserved populations.
Key Responsibilities
Analyze managed care contracts to assess payment methodologies, reimbursement structures, and contract compliance
Assist in financial impact analysis to support payer negotiations and renewals
Review proposed contract terms for financial feasibility and alignment with hospital revenue goals
Investigate and resolve payer-related issues that impact accounts receivable
Monitor and identify trends in payer behavior affecting financial sustainability
Collaborate with billing, coding, and denial management teams to recommend solutions
Act as a liaison between revenue cycle operations and managed care contracting
Participate in cross-functional meetings to improve payer relationships
Partner with finance and billing vendors to ensure accurate contract terms
Communicate findings and recommendations to stakeholders
Required Qualifications
Bachelor's degree in Healthcare Administration, Finance, Business, or related field
Minimum 3-5 years of experience in healthcare revenue cycle, payer analysis, or managed care analytics in a hospital setting
Experience with claims analysis and payer reimbursement methodologies
Preferred Qualifications
Master's degree
Proficient in hospital billing systems (e.g., Cerner) and data tools (Excel, Word, etc)
Knowledge and understanding of DRG, APC, CPT, ICD-10, and revenue codes
Knowledge of Medicare/Medicaid and commercial payer billing regulations
Analytical mindset with attention to detail and problem-solving ability