Position Summary: We have an exciting opportunity to join our team as a FGP Reimbursement Analyst.
In this role, the successful candidate The Managed Care Contract Analyst will contribute directly to the fiscal well-being of the organization by providing accurate analytical support, provide daily maintenance to the contract management system and validate the accuracy of payments from commercial and governmental payers. The analyst is responsible for assisting performing managed care contract compliance analyses as well as preparation of current and projected financial performance models pertaining to payer and physician contracts. Additional responsibilities include analytical support for the preparation of business plans for organizational growth, support of the negotiation process of managed care contracts and other provisions of managed care. The ideal candidate will have a strong knowledge of CPT -4 codes, knowledge of reimbursement methodologies and an understanding of managed care and the revenue cycle process.
Create scheduled system reports to help maintain and ensure the integrity of the contract management system. Be able to interpret issues identified in the reports such as front-end registration errors, provider contract linkage issues, taxonomy code errors, and payer rejection code issues. Prepare monthly claim data downloads for the development of internal reports and the publication of metric driven dashboards to be shared with senior leadership Assist with providing constructive feedback and developing training tools; Work collaboratively across multiple departments within NYU School of Medicine Faculty Group Practice and Clinical Affairs Engage with contracted payers to identify and resolve root cause issues causing payment discrepancies Learn appropriate new software systems to help analyze and evaluate claim data; Work independently, take initiative, and think critically; Function without supervision, request feedback appropriately, and initiate inquiries to gain additional understanding; Adhere to compliance and departmental policies and procedures including compliance with 100% of HIPAA requirements, required trainings, and other Hospital mandated activities; Perform other duties as assigned;
Develop a deep understanding of our revenue cycle process. Communicate issues identified by the contract management system for resolution to internal and external parties including NYU Epic IT, commercial payers and the external vendor of the proprietary contract management system used by the NYU Office of Managed Care
Maintain data integrity verify claims are loaded into the contract management system correctly through conscientious use of tools and system checks
Perform contract audits to identify irregularities caused by contract misinterpretation in our contract management system
Minimum Qualifications: To qualify you must have a Bachelor's degree in Business Administration or related discipline and 3 years experience in healthcare setting with preferably 2-years financial modeling experience preferred or an equivalent combination of education and experience. High level of analytical skills, organization skills, and dynamic communication skills (verbal and written) are required. Proficiency in the use of relational databases, database concepts and software applications; must have MS Access knowledge and be proficient in Excel.
Preferred Qualifications: Ideal candidate will have previous experience in healthcare finance. Skilled in data extraction, analysis and manipulation. Experience with EPIC and the Experian Contract Management system a plus
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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Internal Number: 63191168
About NYU Langone Health
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.