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Managed Care Contract Analyst I
Job SummaryThe Managed Care Contract Analyst I assists in managing the ongoing review of actual payor payments versus expected payments through the process of routine retrospective auditing of payments. Assists with data mining and performing managed care contract analyses for various clients on a regular basis, including summarizing financial trends and impacts for Hospital, Physicians' Organization, and Pediatric Physicians' Organization at Children's Hospital (PPOC). Aides in the development of auditing schedules, tracking mechanisms and coordinating the pursuit of the recovery of net revenue, rebilling of claims and/or settlement opportunities. Helps identify over and underpayments based on contract intent. Extensive
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