Claim Analytics Manager | Permanent WFH

The Manager Claim Analytics role is an integral part of the overall financial plan for LucidHealth. This position supports the data needs of the national Revenue Cycle presence and is also called upon to study the outcome of claims that have achieved a zero balance. While the main internal customer is the Revenue Cycle service area, the position may be offered to support other strategic needs and initiatives as well. LucidHealth is excited to present the opportunity to an individual who is idea-centric, goal-oriented, accountable and prides themselves in doing what others say cannot be done. The position has first-level interactions with the Director Payor Relations and also the Vice President of Revenue Cycle. This role is essential to help various stakeholders in the organization interpret data outcomes so that revenue opportunities can be achieved.   

Key Responsibilities:

• Establish a regular protocol to identify claims that have achieved a zero balance and isolate the payments, adjustments and other essential components of the transaction history for the purpose of understanding those claim behaviors. 
• Summarize the behavior of those zero claims by major payor group, specific insurance plan and also to the group level within insurance plans as needed.
• Serve as a subject matter expert on custom report writing, data warehouse and data lake functions within and connected to Revenue Cycle.  
• Provide custom report writing as needed to monitor and quantify transactional activity associated with Specialty Vendors who also serve Revenue Cycle needs.
• Provide direct support and feedback to Revenue Cycle leaders where data needs exist and work with the Director Payor Relations and Vice President Revenue Cycle to prioritize those requests.
• Obtain an advanced knowledge or core Revenue Cycle platforms to further enhance information and outcomes.
• Drive excellence by assuring the highest quality of output reporting within the Revenue Cycle and other areas called upon for support.
• Attend various internal meetings to gain knowledge of Revenue Cycle operational needs and challenges.
• Offer feedback, guidance and recommendations into areas of need based upon knowledge and/or experience.
• Assist internal leadership within Revenue Cycle by interacting with other software vendors as needed. 
• Publish a monthly internal report on activities for executive leadership.
• Assuring, documenting and returning value to the organization in excess of the compensation package.

Requirements

• A Bachelor's degree graduate in a related field of study.
• A minimum of 7 years of occupational experience in the financial side of the healthcare sector with an emphasis on Revenue Cycle, analytics, custom report writing and data management.  
• Proficiency in correspondence, presentations and other communication methods.
• Ability to partner with various stakeholders and facilitate collaboration therein.
• Demonstrating and practicing a sense of urgency with work responsibilities.
• A preference for proficiencies in data science (including SQL, Alterix, PowerBI) to facilitate data extraction.

Benefits

• Permanent Work From Home
• Weekly Paychecks
• Fixed Weekends Off
• HMO Reimbursement on your 90th day
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary

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