Provider Reimbursement Analyst

A company is looking for a Provider Reimbursement Analyst who will analyze provider reimbursement fluctuations and ensure accurate capitation payments. Key Responsibilities Compile and analyze weekly claim runs to explain variances and fluctuations Resolve provider reimbursement issues, including capitation and claim refunds Ensure accuracy of capitation payments by reviewing and investigating capitation data Required Qualifications Bachelor's Degree or equivalent, required Three years of managed care and healthcare experience, preferred Experience in communicating with technical and business constituencies Ability to prepare capitation analysis reports Familiarity with provider reimbursement processes

Apr 29, 2025 - 17:15
 0
Provider Reimbursement Analyst
A company is looking for a Provider Reimbursement Analyst who will analyze provider reimbursement fluctuations and ensure accurate capitation payments. Key Responsibilities Compile and analyze weekly claim runs to explain variances and fluctuations Resolve provider reimbursement issues, including capitation and claim refunds Ensure accuracy of capitation payments by reviewing and investigating capitation data Required Qualifications Bachelor's Degree or equivalent, required Three years of managed care and healthcare experience, preferred Experience in communicating with technical and business constituencies Ability to prepare capitation analysis reports Familiarity with provider reimbursement processes