Financial Analyst

Overview

Provides data retrieval, contract modeling, and financial analysis support to leadership, including Directors, VPs, and Managed Care Regional Contracting Directors.

Responsibilities

• Retrieve reimbursement data from hospital and physician accounting systems.
• Build financial models to analyze and evaluate the reimbursement impact of hospital and physician payer reimbursement methodology proposals.
• Work with Managed Care Regional Contracting Directors on contract interpretation issues to ensure accuracy of contract models and financial analysis.
• Produce clear and concise written reports summarizing payment modeling analysis.
• Perform QA for monthly data loads.
• Complete special projects and reports as needed.

Qualifications

• Well versed in reimbursement methodology, including DRG, APC, COPPS, OPPS, Case Rates, Per Diems, HCPCS, and CPT Code Fee Schedules (2-5 years’ experience).
• Familiar with hospital and physician billing and coding terminology, including diagnostic codes, revenue codes, procedure codes, and HCPCS codes.
• Well versed in healthcare product lines, including HMO, PPO, HIX, Medicare, Medicaid, Tricare, and Workers Comp.
• Ability to clearly communicate complex and technical issues in writing and verbally.
• Ability to work independently and manage multiple projects simultaneously.

Computer Skills

• Knowledge of Word Processing software.
• Exceptional skills in Excel.
• Knowledge of contract modeling systems such as FinThrive (preferred).
• Knowledge of Access or SQL (preferred).

Education & Experience

• Bachelor’s degree required; emphasis in Accounting or Data Analytics preferred.
• 2-5 years’ work experience required.
• Prior experience in hospital, physician, or health plan financial analysis, or equivalent experience preferred.
• Experience modeling and/or working with health plan/hospital and physician managed care commercial and Medicare reimbursement methodologies and terminology.