What are the responsibilities and job description for the Payer Provider Analyst position at GBMC HealthCare?
Under general supervision, coordinates and supports the Health Services Cost Review Commission Redesign Programs, the Medicare Shared Savings Program, Merit Based Incentive Payment System, CRISP, and the Medical Staff's credentialing processes required for payer activation, billing and incentives under these programs as well as commercial and other insurance company entities. Further will provider regular support to the reporting and analytic process for the above mentioned programs, including the processing of applicants for initial and continuing Staff membership and requests for interim/temporary privileges. Prepares reports and provides data base support to the initial, provisional, and reappointment processes.
Education
Bachelor's degree or 2 years of equivalent experience
Experience
One year in a Medical Staff Office or Managed Care Department
Skills
- Knowledge, proficiency and usage of EPIC and all payer reporting portals
- Knowledge of all aspects of and criteria regarding CCIP, MIPS, MACRA, CRISP, MSSP and other payer healthcare programs
- Experience using Microsoft Excel
- Effective written and oral communication skills to communicate effectively with staff, physicians, organization administration and various payer programs
- Skill in using computers and personal productivity applications
- Skill in data analysis and reporting, creating ad hoc reports
- Ability to analyze and interpret data
- Ability to type quickly and accurately
- Ability to develop and maintain effective relationships with a variety of contacts and programs
Licensures, Certifications
NONE
Physical Requirements
- Ability to sit and concentrate and pay close attention to detail due to legal implications of the various CMS, HSCRC, and payer programs as well as the appointment and reappointment processes, for upholding the credibility of the Medical Staff organization and hospital. Ability to work independently with minimal supervision
Working Conditions
- Works in normal office environment
Location: GBMC HealthCare · Managed Care
Schedule: Full Time, Day 8 Hour Shifts (7 am - 3:30 pm), 40
Payer Operations - Senior Associate
PwC -
Baltimore, MD
Payer Operations - Manager
PRICE WATERHOUSE COOPERS -
Baltimore, MD
Payer Relations Specialist
University of Maryland Medical System -
Baltimore, MD