Financial Analyst II for Payor Contracting (Remote)

Job Posting Description

The Financial Analyst II for Payor Contracting (Remote) helps manage the ongoing review of actual payor payments versus expected payments through the process of routine retrospective auditing of payments. Responsible for data mining and performing managed care contract analyses for various clients on a regular basis, including summarizing financial trends and impacts for Hospital, Physicians' Organization, and Pediatric Physicians' Organization at Children's Hospital (PPOC). Aides in the development of auditing schedules, tracking mechanisms and coordinating the pursuit of the recovery of net revenue, rebilling of claims and/or settlement opportunities.

This Financial Analyst II for Payor Contracting will be responsible to:
• Designs and builds financial models to support various reporting and contracting needs, including payer contract negotiations on behalf of the Hospital, Physicians' Organization, Pediatric Physicians' Organization at Children's Hospital (PPOC), and Boston Childrens Health Physicians (BCHP)
• Develops methodologies and leverages internal reporting systems to gather and compile the required data. Employs significant understanding of Hospital/physician contractual reimbursement methodologies and non-fee-for-service arrangements
• Prepares appropriate analyses for review by various committees and senior leadership. Makes recommendations regarding contract terms and fees
• Performs detailed analyses of various commercial and governmental contract performance, including patient detail account transaction activity review for payment collection accuracy
• Maintains and updates the Managed Contract System based on commercial and governmental contracts. Performs system set up and testing as necessary to ensure contracts are accurately configured and modeled
• Assists Analyst I in compiling quarterly and annual Hospital/physician fee schedules by payer contracts
• Creates, organizes, and maintains files using database and spreadsheet programs; compiles data into required reporting formats, including Excel and Powerpoint presentations
To qualify, you must have:
• A Bachelor's degree is required, preferably in Business/Finance/Economics or a closely related field, and at least 2-3 years of related experience in financial analysis, preferably in a Healthcare setting.
• Understanding of payer contracts and documents relevant to healthcare reimbursement
• Skilled at identifying trends and understanding content within data
• Possesses some knowledge of ICD-10, CPT and HCPCS codes, Medicare RVU, and DRG coding methodologies
• Insight into contracting reporting systems and data output, with the ability to identify opportunities for enhanced practices
• Strong technical skills and proficiency with MS Office applications, especially Excel
• This position is 100% remote, with opportunity for flexible work schedule.
Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

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