Cost Containment Analyst

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Sante Health System in Fresno, CA is looking to hire a full-time Cost Containment Analyst who will be responsible for identifying and analyzing cost saving opportunities including establishing and maintaining all phases of reinsurance filing, interpreting stop loss contracts, meeting filing deadlines and maintaining correspondence and tracking logs.

OUR IDEAL COST CONTAINMENT ANALYST

• Career-minded - ready to take the next step in your career
• Positive - a can-do attitude that helps you rise to challenges
• Team Oriented - enjoy working with and leading others with enthusiasm and positivity
• Detail-oriented - a commitment to achieving a high level of accuracy and attention to detail
• Self-motivated - no-task-too-small approach to the work, sees what needs to be done and does it
• Efficient - a knack for effectively prioritizing tasks and managing your time

REQUIREMENTS

• High School Diploma/GED equivalent required
• 2 years of relevant experience in managed care setting

Candidates should have exceptional people and communication skills, be highly skilled in multi-tasking in a fast-paced environment, a commitment to achieving a high level of accuracy and attention to detail, and a no-task-too-small approach to the work. If you meet the above requirements and are ready to take the next step in your career, apply now!

ESS ENTIAL DUTIES AND RESPONSIBILITIES

• Identify, develop and implement cost saving opportunities.
• Performs adjustments. (JAA and MCS).
• Works Blue Cross JAA reports.
• Communicates with Anthem via emails regards to Claims status.
• Performs voids and reissues.
• Works JAA reconciliation reports.
• Splits RFF for Stoploss.
• Request provider/ member overpayments.
• Oversees Third Party liability process.
• Track error trends and provide feedback to appropriate departments.
• Attends meetings and training sessions as required.
• Maintains strictest confidentiality.

ABOUT SANTE HEALTH SYSTEM

Sante Health System is a Management Services Organization that serves multiple clients. "Sante" is the French word for health. Our name symbolizes our commitment to good health, progressive care, and leadership in our community. Sante is one of the largest healthcare claims and billing management companies in Central California. The strength of Sante is the extraordinary network of physicians, health plans, and other health service providers it offers the people of our valley. Sante coordinates with physicians, health plans, hospitals, and ancillary providers to ultimately benefit the patient in a managed care environment. Sante Health System provides numerous client services such as billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management. Sante is celebrating over 25 years of service to the community. We deeply understand that we would not be successful in enhancing the quality of life of our patients without our incredible team. This is why we have created a work culture that is comprised of talented, driven, dedicated, innovative, and service-driven professionals. We provide competitive pay, excellent benefits including medical, dental, vision, and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Being part of our team is like being part of a big family. Join our team and make Sante Health System your home away from home.