PCON/Managed Care Analyst

Dallas, TX 75201

Posted: 09/21/2018 Industry: General Job Number: 36484

PCON/Managed Care Analyst

POSITION SUMMARY:

Under the direct supervision of the Manager, Revenue Management, the PCON/Managed Care Support Rep researches and resolves assigned contractual patient account issues.

KEY RESPONSIBILITIES:

·         Perform validation of reason codes for technical overpayments as documented on the account or correspondence. (Overpayments/Underpayments based on clinical reasons will be handled by Clinical Appeals)

·         Resolve account discrepancies

·         Monitor third party payer trends via assigned reports

·         Escalate contract issues to the Manager

·         Practice and adhere to the “ Code of Conduct” philosophy and “ Mission and Value Statement”

·         Other duties as assigned

·         Supportive of the compliance program set forth by our client as demonstrated by:

·         Upholding the Code of Conduct and Corporate Compliance.

·         Adhering to and helps to enforce all compliance policies relevant to his/her area.

·         Assuring timely compliance education as requested by the Regional Compliance and Safety Officer and/or through corporate initiatives.

·         Sets an example to all staff in daily activities.




REQUIRED KNOWLEDGE & SKILLS:

·         Communication - communicates clearly and concisely, verbally and in writing

·         Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

·         Interpersonal skills - able to work effectively with other employees, patients and external parties

·         Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and Systems

·         Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately




EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

I.Education:HS Diploma or GED required.

II.Experience:At least one year of related experience. Relevant education may substitute experience requirement.

III.Software/Hardware:PC skills - demonstrates proficiency in PC applications as required.
Donovan & Watkins, a Brand of BG Staffing, Inc. (NYSE American: BGSF), delivers the just-in-time talent that organizations need to effectively compete in the modern business landscape. Donovan & Watkins matches critical talent in the Finance & Accounting, Engineering, Legal, Administrative & Clerical and Human Resources fields to a diverse range of clients and client needs. To learn more about our services, visit www.donwat.com.

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