Analyst, Provider Analytics

Job Description

The Analyst, Provider Analytics is primarily responsible for meeting production and quality expectations. The analyst will develop and manage provider relationships, work independently to identify and secure provider refunds, and serve as a relationship liaison for business development opportunities.

Role Qualifications

  • Proficiency with MS Office Suite required (Excel, Visio, PowerPoint etc.)
  • Excellent organization and communication skills including the ability to work effectively in a matrixed environment
  • Excellent written, oral, and interpersonal skills
  • Ability to work independently and in a high-performance team environment
  • Preferred experience in healthcare revenue cycle/financial operations
  • Preferred experience with health insurance contract interpretation
  • Willingness to travel overnight as necessary

Position responsibilities

  • Review and analyze client data for accurate resolutions
  • Accountable for meeting/exceeding production goals both internally and externally
  • Develop monthly goal objectives for assigned provider
  • Management of provider accounts receivable, denials analysis, and quality evaluation
  • Build and develop effective provider relationships
  • Interpret client contract language for variance analysis
  • Respond to provider/payer requests in a timely manner
  • Other duties as assigned

Skills and Experience

  • High School Diploma/GED required; Bachelor’s Degree preferred
  • Effective time management skills
  • Goals and results oriented
  • Strong communication skills
  • Ability to work independently in an environment of continual change
  • High degree of accuracy, thoroughness, and attention to detail
  • Strong computer/data entry skills
  • Ability to maintain and enhance existing customer relationships
  • Strong analytical skills

Demands and work environment

The demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Other demands may, from time to time, be required.

  • Physical demands: While performing the duties of this job, the employee is regularly required to sit, stand, walk; use hands and fingers to handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Frequent travel for this position may be required.
  • Mental demands: While performing the duties of this job, the employee is regularly required to understand and follow oral/written instruction, guide and or give instruction, and make decisions in accordance with established procedures and policies.
  • Work Environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time. Travel is determined based on workload.

To apply to this position please send your resume to and reference the position: Claims Analyst.

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