Job Summary:

The Financial Analyst would be responsible to providing systems applications and maintenance support to end users in Managed Care and Patient Accounts department. Responsibility involves performing complex financial analysis to project revenue and utilization for Physician and Hospital services. It requires contact with other departments, and their department heads to ensure that objectives as they relate to reimbursement are met. Travel as required to other sites. Does related work as required.

Responsibilities:

* Responsible for maintaining managed care contracts in system including reimbursement formulas/calculations in accordance with payment methodology (DRG, Medicare/Medicaid, Managed Care - Commercial, etc,). Validates payment rate calculations and prepares queries and reports from application systems as required.* Use various reporting tools to perform contract error analysis and classify patient population for accurate reimbursement.* Generate reports from various systems.* Applies third party methodologies in order to analyze profitability of the various reimbursement methodologies.* Uses computer applications or other automated systems such as spreadsheets, word processing, calendar, e-mail and database software in performing work assignments.* Writes and maintains reimbursement formulas/calculations based upon managed care or third party agreements including user notes and other custom documentation about departmental systems and expected output.* May access protected health information (PHI) in accordance with departmental assignments and guidelines defining levels of access (i.e. incidental vs. extensive).* Perform other incidental tasks, as needed.Qualifications/Requirements:

Experience:

3 years of experience working with reimbursement methodologies (DRG's, managed care, medicare, etc.) for a managed care organization, health care consulting firm, or in a hospital division of Finance, Reimbursement or Patient Accounts, required.

Education:

A Bachelor's Degree in Finance, Business Administration or a closely related field, required. A Master's Degree in Finance, Health or Hospital Administration may be substituted for one year or the above experience.

Licenses / Certifications:

Other:

Good knowledge of the principles and practices of hospital administration; good knowledge of reimbursement methodologies, including Diagnostic Related Groups (DRG's) as defined by Medicare and New York State; ability to perform analytical reviews of rates in order to ascertain their implications for hospital; ability to learn and efficiently load managed care rates into contract systems; ability to deal effectively with a wide range of professional, administrative, technical and clerical personnel; ability to communicate effectively both orally and in writing; good knowledge and ability to use Windows based office software; sound and mature judgmentSpecial Requirements: Advanced user of Microsoft Office products. Extensive knowledge in support of business critical systems, including such technical areas as PC equipment, PC operating systems, and their functional capabilities; ability to analyze and understand organizational structure, functions, operations, goals and objectives in support of the installation of application and office software.

About Us:

NorthEast Provider Solutions Inc.