Reimbursement Analyst

1 week ago


Los Angeles, United States Platinum Resource Group Full time
Job DescriptionJob Description

Provider Reimbursement Analyst needed on a contract basis to assist our insurance client with their IPA payment integrity. 

Location: Southern California preferred

JOB DESCRIPTION

Provider Reimbursement Analyst needed to research, quantify, and recoup Independent Physician Association fees. Will need to dig into billing and contracts and make determinations on under billings, coordinate billings, and update systems and processes to ensure correct future IPA billings.

  • Analyze and evaluate financial data related to provider contracts, claims and reimbursements.
  • Utilize financial models and reporting, and collaborate with cross-functional teams including IT, Finance, Provider Network, and others to optimize provider networks and enhance financial performance.
  • Facilitate business process improvement via methodical investigation, analysis, review, and documentation of business requirements from all applicable enterprise data sources.
  • Demonstrate a high level of subject matter expertise in Managed Care operations.
  • Review submission of data against established benchmarks and coordinate correction and improvement efforts.

 

QUALIFICATIONS

  • Bachelor's Degree in Finance or Related discipline.
  • 5+ years of successful experience in a quantitative role as a Financial Analyst, Accounting representative, or Reimbursement Analyst. 
  • Experience with analyzing various types of provider (capitation and Fee For Service) contracts including IPAs.
  • Knowledge of Medi-Cal and Medicare Fee Schedules.
  • Excellent verbal and written communication skills.
  • Problem solving skills evidenced by demonstrated results in past positions.
  • Ability to work under tight deadlines and handle multiple/detail-oriented tasks.
Company DescriptionPlatinum Resource Group is a professional level consulting firm, providing resources to Fortune 1000 client companies in the areas of technology, human resources, accounting, finance, business systems and supply chain, on a contract and interim basis. PRG has operations in Orange County, San Diego, Los Angeles and San Francisco. As a W-2 employer we offer our consultants direct deposit bi-weekly payroll, health, dental, vision benefits, paid holidays, and referral bonuses.Company DescriptionPlatinum Resource Group is a professional level consulting firm, providing resources to Fortune 1000 client companies in the areas of technology, human resources, accounting, finance, business systems and supply chain, on a contract and interim basis. PRG has operations in Orange County, San Diego, Los Angeles and San Francisco. As a W-2 employer we offer our consultants direct deposit bi-weekly payroll, health, dental, vision benefits, paid holidays, and referral bonuses.
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