Senior Program Manager - Healthcare Reimbursement

Job Description

Greetings from myAvtar!!! Congratulations! Your Resume has been short listed for position of Senior Program Manager - Healthcare Reimbursement with one of our Reputed Healthcare clients for Gurgaon Location. Job Description: What you will do: • To design, analyze and maintain healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts. • To perform various analytical reviews and deep-dives (root cause analysis) on client-specific healthcare reimbursement methodology to ensure accuracy of revenue projections and actual collections. • To report/highlight the exceptions in reimbursement method by building contract models for Hospital charges. • To effectively communicate the findings/ observations with recommended action to US team/clients. • Maintain MIS related to analysis, Accuracy and coverage report for maintenance databases. • Handling client calls and communicating effectively for task deliverables and site maintenance. What will you need: • Graduate degree Preferably in Statistics\ Mathematics\ Economics\ Commerce\Finance from a reputed educational institute. • Good analytical and algorithm building skills, having experience to build contract models for hospital charges to calculate expected reimbursement. • Skills to read, understand and interpret reimbursement contracts between hospitals and insurance providers. • Experience/knowledge of various US healthcare reimbursement methods like MS DRG weightage, Multipliers, % of charges, outliers, Grouper fee schedule etc. • Good Communication Skills (both written & verbal). • Preferable - 1-3 years of experience in US healthcare. • Having good knowledge about RCM cycle and denial management.