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Revenue Cycle Escalation Unit, Analyst

Catholic Health Service
Melville, NY Full Time
POSTED ON 1/16/2025
AVAILABLE BEFORE 4/13/2025

Overview :

Catholic Health is one of Long Islands finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes to every patient, every time.

We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace!

Job Details :

Manage underpaid insurance balances that are unable to be resolved through routine follow-up activities. Position requires a thorough understanding and knowledge of managed care contracts, practice and policy.

Job Responsibilities :

  • Contributes to and consistently applies CHS Services' policies, procedures, and benefits to all customers and / or employees without discrimination.
  • Employee conducts himself / herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself / herself in conformity with the CHS Security policies and procedures.
  • Quantify and communicate trends in payer activity
  • Assist in the validation of contracts as loaded in contract management systems
  • Works with Managed Care Directors on recovery efforts tied to identified variances.
  • Conducts follow-up activities with payers as assigned.
  • Conducts rate analysis for rate recycling.
  • Prepares and maintains revolving spreadsheets.
  • Prepares settlement files.

Requirements and Qualifications :

  • Bachelor's degree preferred, comparable work experience considered in lieu of bachelor's degree.
  • Proficient in designing, building reports and analyzes in various Microsoft based data analysis tools. Proven experience working with large and complex SQL databases preferred.
  • Ability to analyze and accurately summarize complex claims data and effectively communicate conclusions
  • Previous experience with analysis preferably in a healthcare or managed care setting is required for this role.
  • Experience with hospital billing and or decision support systems a plus.
  • Strong knowledge of the managed care environment including provider, payer, and employer.
  • Ability to work interdepartmentally and independently
  • Ability to work on multiple projects in a fast-paced environment
  • Posted Salary Range :

    USD $70,000.00 - USD $95,000.00 / Yr.

    This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidates qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses / incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

    At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.

    Salary : $70,000 - $95,000

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