Analyst Managed Care Reimbursements (Remote) - Physicians Billing Services

About the role

Position is responsible for developing fee schedule proposals, maintaining fee schedule data, and managing Managed Care pricing and rate contracting strategy.

Responsibilities

• Develops fee schedule proposals as well as counter proposals to assist in the negotiation and implementation of all reimbursement related contract terms.
• Maintains fee schedule data for all commercial and government payers.
• Responsible for both managed care and transplant fee schedule integrity.
• Ensures that all fee schedules are appropriately updated and communicates changes to WashU Departments, PBS and other appropriate parties.
• Develops schedules and strategies to maximize the annual updates to fee schedules that represent $300,000,000 in annual revenue.
• Identifies contracting opportunities to enhance net revenues and actively advises Departments.
• Maintains transplant contracting database.
• Fosters teamwork, innovative thinking and knowledge sharing with Departments, PBS and Contracting to enhance contract integration.
• Provides or coordinates high level analysis and reporting support to PBS and the Faculty Practice Plan (FPP).
• Maintains transplant contracting database.
• Monitors, understands and articulates industry and government trends which impact managed care pricing –including but not limited to: CPT-4, HCPCS level II, revenue coding.
• Interprets managed care contracts and assists Department leadership as well as PBS Revenue Integrity/MPV team in resolving reimbursement disputes with payers.
• Works closely with the representatives of various managed care organizations, WUSM faculty, WUSM Department Business Managers, various WUSM staff and BJC Managed Care Contracting.

Requirements

No specific education, certifications, professional licenses, work experience, skills, or driver's license are required for this position.

Qualifications

• Bachelor’s degree or combination of education and/or experience may substitute for minimum education.

Skills

• Analytical Thinking
• Computer Literacy
• Detail-Oriented
• Epic EHR
• Health Administration
• Health Care Systems
• Interpersonal Communication
• Managed Care Operations
• Microsoft Access
• Microsoft Excel
• Oral Communications
• Self-Direction
• Statistics
• Written Communication

Benefits

• Personal: Up to 22 days of vacation, 10 recognized holidays, and sick time.
• Competitive health insurance packages with priority appointments and lower copays/coinsurance.
• Take advantage of our free Metro transit U-Pass for eligible employees.
• WashU provides eligible employees with a defined contribution (403(b)) Retirement Savings Plan, which combines employee contributions and university contributions starting at 7%.
• Wellness: Wellness challenges, annual health screenings, mental health resources, mindfulness programs and courses, employee assistance program (EAP), financial resources, access to dietitians, and more!
• Family: We offer 4 weeks of caregiver leave to bond with your new child. Family care resources are also available for your continued childcare needs.
• We cover the cost of tuition for you and your family, including dependent undergraduate-level college tuition up to 100% at WashU and 40% elsewhere after seven years with us.