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1 month ago

Job Summary

We are seeking to recruit a Cost Containment Accountant who will be responsible for analyzing, monitoring, and controlling healthcare costs within the organisation. This role involves identifying areas of potential cost savings, implementing strategies to contain expenses, and evaluating the financial impact of various initiatives.

  • Minimum Qualification: Degree
  • Experience Level: Senior level
  • Experience Length: 6 years

Job Description/Requirements

Responsibilities:
  • Analyze healthcare claims data, financial statements, and cost trends to identify opportunities for cost containment and efficiency improvements.
  • Prepare financial reports, variance analysis, and forecasts to track healthcare costs, identify budget variances, and communicate financial performance to management.
  • Collaborate with internal stakeholders, including actuarial, underwriting, and claims management teams, to design and implement effective cost containment measures.
  • Review and audit healthcare claims to identify billing errors, fraudulent activities, and opportunities for cost recovery.
  • Implement controls and procedures to prevent improper payments and ensure compliance with billing regulations and contractual agreements.
  • Participate in provider contract negotiations to secure favourable pricing terms, reimbursement rates, and performance incentives.
  • Monitor contract compliance and performance metrics, identifying areas for renegotiation or improvement to achieve cost savings targets.
  • Evaluate healthcare utilization patterns and trends to identify opportunities for cost-effective care delivery and resource utilization.
  • Implement utilization management strategies, such as pre-authorization requirements, case management programs, and provider education initiatives, to optimize healthcare utilization and reduce unnecessary costs.
  • Stay informed about regulatory changes, healthcare industry trends, and best practices related to cost containment and reimbursement methodologies.
  • Collaborate with cross-functional teams, including finance, claims, and provider relations, to develop and execute cost containment initiatives aligned with organizational goals and objectives.



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