Payor Strategy Analyst

BA/BS in Business, Finance, Accounting or other related fields preferred
2-3 years of data analysis experience in healthcare or related fields
Advanced skills with Microsoft Excel required
SQL, SAS, or other data querying software experience preferred
Broad knowledge of healthcare insurance, physician billing and reimbursement, administration, systems, practices, and principles, (i.e. Medicaid, Medicare, Medicare Advantage, and Commercial.)
Has demonstrated ability to review large data files for accuracy and completion
Has ability to excel in fast paced environment, take direction and handle multiple priorities
Strong written and verbal communication skills including the ability to communicate results of data analysis to a variety of stakeholders.

Analyzes rate fee schedules and claims data to make recommendations for contract negotiations and pricing strategies
Creates financial models to assess different contract scenarios and pricing strategies that impact patient revenue and utilization
Creates the needed reporting to track key performance indicators related to payer contracting, such as patient volume, reimbursement rates and payer denials
Organizes and maintains database of all contracted rates for WellNow Urgent Care
Oversees that contracted rates are loaded into internal systems and audited to ensure its success
Responsible for fee schedule compliance and maintenance to ensure that accurate rates are used in expected payment calculations
Work cross departmentally to address any payer or claims related issues
Creates ad hoc reports and analysis as required