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Provider Reimbursement Analyst

Company: Beacon Health Options
Location: Cypress
Posted on: May 7, 2020

Job Description:

Beacon Health OptionsJob Category: Provider & Network - GeneralReq #: PROVI01897Schedule: Full TimeLocation: CA - CypressWe Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a 'world-class' candidate experience from the moment you click 'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Provider Reimbursement Analyst a highly organized and compassionate professional to join our team. Develop and maintain the behavioral health professional reimbursement methodologies for existing, as well as new markets. Conduct benchmarking analysis of current fee schedules to Medicare and/or Medicaid. Conduct market research and analysis of OP provider fees and higher level of care contracting rates. Development and maintenance of company-wide, default provider rate sheets and fee schedules for distribution to key internal areas of operations and ensure approved fee schedules are entered into all appropriate data systems.

What does a typical day look like?

  • Develop/update and facilitate the annual loading of benchmark professional fee schedules (Medicare, Medicaid, and Beacon Proprietary) in conjunction with each Region's provider strategy.
  • Serve as the subject matter expert regarding specific reimbursement, fee schedules and rates for new client implementations and upsells for existing clients. Execute implementation activities related to reimbursement.
  • Monitor and assure implementation of cycle as well as off cycle code additions/deletions to benchmark fee schedule and update existing Beacon fee schedules for cross-walked codes.
  • Analyze the financial impact of updated professional fee schedules for both risk and ASO business.
  • Support the development, implementation and maintenance of desktop modeling tools for professional rate increases.
  • Partner with System Advisor team to identify system design/architecture requirements for loading fee schedules.
  • Utilize reporting tools to index facility rates by level of care and place of service as a percent of benchmark reimbursement levels.
  • Support the Network Strategy department's process improvement and transformational initiatives to drive completion and successful outcomes.
  • Develop strong relationships with Regional teams built on trust and collaboration.
  • Act as liaison and maintain productive working relationships with all Beacon departments.
  • Other duties as assigned.
    What you Contribute?

    Education: Bachelor's Degree required.

    Licensure: N/A

    Knowledge, Skills & Abilities:
  • Three to Five (3-5) years of progressively responsible professional reimbursement experience.
  • Three (3) years of provider relations and/or contracting experience preferred
  • Two to four (2-4) years healthcare payor (including managed care) experience
  • 2+ years of multi-state provider reimbursement experience preferred
  • Experience and comfort with financial model and detailed data analysis
    What Makes Us Different?
    • Here, it's not just a job - it's an opportunity to change lives.
    • Our employees are learners, innovators and original thinkers.
    • Our mission and values guide the way we treat our members, providers and each other.
      What We Have to Offer:
      • Healthcare benefits available starting day 1!
      • Health & wellbeing incentives, such as gym membership reimbursement
      • 401K with company match to help reach your future financial goals
      • Generous PTO, because we know life happens outside of work
      • Tuition reimbursement so you can keep reaching your fullest potential
        If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

        Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

        At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

        #CB

        #GD

        #LI-7CF1

        PM16

        $REM

        PI120095381

Keywords: Beacon Health Options, Cypress , Provider Reimbursement Analyst, Professions , Cypress, California

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