What are the responsibilities and job description for the Payor Stratergy Analyst position at Team TAG Services, LLC?
The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S., supporting 15,000 healthcare professionals and team members at more than 1,000 health and wellness offices across 46 states in three distinct categories: Dental care, urgent care, and medical aesthetics. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. ADMI provides a comprehensive suite of centralized business support services that power the impact of four consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care and Chapter Aesthetic Studio. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.
Job Summary
This position plays a vital role for WellNow Urgent Care, supporting the Payer Strategy team through data analysis, performance reporting, contract modeling and ownership of fee schedule maintenance and system loads. The successful candidate will report to the Sr. Director of Plan Management & Metrics on the Payer Strategy Team.
Responsibilities
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
Minimum Education and Experience
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.
Salary:
Annual pay range: $72-85k
A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match
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Salary : $72,000 - $85,000
