Network Contract Analyst
Location
Pennsylvania
Posted
65 days ago
Salary
$63.4K - $119.4K / year
Seniority
Mid Level
Job Description
Network Contract Analyst
Capital Blue Cross
• Perform contract administration activities including the preparation of contract settlements • Ensure claims are paid in accordance with contract provisions and plan payment levels • Perform research, analytic, and reporting work in support of Provider Contracting and Value Based Programs • Work with team manager and other analysts to develop and administer contracts with healthcare providers • Prepare provider contract settlements ensuring accuracy and compliance with payment provisions • Manage Cost Rate Adjustment (CRA) process • Respond to inquiries and resolve reimbursement issues from providers • Develop proactive analytical studies on provider billing patterns
Job Requirements
- 2-3 years’ experience in a health care environment with proven analytical expertise is desired
- Proven understanding of Capital BlueCross provider contract provisions
- Knowledge of general accounting practices and auditing procedures/techniques
- Familiarity with Medicare and Medicaid reimbursement methodologies (facility and professional providers)
- Demonstrated knowledge of and development experience with various tools such as Microsoft Office Suite products (Access, Excel, Word, etc.), Crystal Reports, Tableau, and SAS
- Ability to perform at an intermediate skill level in Access including query development, table joins and formulas
- Ability to perform at an intermediate level in Excel utilizing formulas, pivot tables and other functions/formulas
Benefits
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off, Holidays, and Volunteer time off
- Incentive Plan
- Tuition Reimbursement
- Flexible environment for health and well-being
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