[Remote] Analyst Reimbursement Managed Care - Remote

Note: The job is a remote job and is open to candidates in USA. AdventHealth is a community-focused organization dedicated to uplifting individuals in body, mind, and spirit. They are seeking an Analyst Reimbursement Managed Care who will utilize strong analytical and problem-solving skills to address complex issues related to reimbursement and credentialing. Responsibilities Demonstrated strong analytical reasoning, critical thinking, judgment, and problem-solving skills in order to independently assess, interpret, and address complex issues in a continually changing environment Demonstrated strong computer software skills including Microsoft Office applications, with a proficiency in Microsoft Excel and the ability to work with and manipulate data within Reports, Formulas, Charts, and Pivot Tables Submits credentialing reports accurately and timely Confirms provider information on credentialing applications and reports Enters effective date and provider number information from payers into relevant systems Reviews and resolves claim denials related to credentialing and enrollment status Identifies and analyzes payment variances for professional fee contracts and government payers Reviews reports to determine true variances based on reimbursement guidelines and contracted fee schedules Liaises with payers to address issues and ensure accurate processing Works closely with Managed Care contract administration to ensure accurate provider profiles Maintains knowledge of current rules and regulations of Commercial and Government programs Aggregates and categorizes variance types for management review Serves as a resource for payment variance identification and education Coordinates with billing support teams on identified payment variances and credentialing denials Other duties as assigned Skills Bachelor's, High School Grad or Equiv (Required) Demonstrated strong analytical reasoning, critical thinking, judgment, and problem-solving skills in order to independently assess, interpret, and address complex issues in a continually changing environment Demonstrated strong computer software skills including Microsoft Office applications, with a proficiency in Microsoft Excel and the ability to work with and manipulate data within Reports, Formulas, Charts, and Pivot Tables Submits credentialing reports accurately and timely Confirms provider information on credentialing applications and reports Enters effective date and provider number information from payers into relevant systems Reviews and resolves claim denials related to credentialing and enrollment status Identifies and analyzes payment variances for professional fee contracts and government payers Reviews reports to determine true variances based on reimbursement guidelines and contracted fee schedules Liaises with payers to address issues and ensure accurate processing Works closely with Managed Care contract administration to ensure accurate provider profiles Maintains knowledge of current rules and regulations of Commercial and Government programs Aggregates and categorizes variance types for management review Serves as a resource for payment variance identification and education Coordinates with billing support teams on identified payment variances and credentialing denials Other duties as assigned Benefits Medical, Dental, Vision Insurance Life Insurance Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Company Overview AdventHealth is a nonprofit healthcare system providing whole-person care through hospitals, clinics, and virtual services. It was founded in 1973, and is headquartered in Altamonte Springs, Florida, USA, with a workforce of 501-1000 employees. Its website is