Top 2 Claims analyst Jobs in Tyler, Tx

Senior Analyst
Andrews Center —Tyler, TX
- Full-time
- Mid-level
- Finance
- Bachelor's degree
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Andrews Center —Tyler, TX
Contract Metric Tracking: Monitor and model state-mandated performance metrics (e.g., target population service caps, crisis response times, and utilization…
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Senior Analyst

Andrews Center -
Tyler, TX

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Job Details

Full-time
2 days ago

Qualifications

Business intelligence tools
Bachelor's degree
Power Pivot
Data analysis software

Full Job Description

Education: Bachelor's degree in Finance, Business Administration, Accounting, Economics, Public Administration, or a quantitative data field.
Experience: 4-6 years of corporate finance, financial planning & analysis (FP&A), or public sector fund accounting experience.
Required Experience: At least 2 years working within an LMHA, public behavioral health network, state-funded healthcare system, or a Medicaid-heavy health provider environment.
Technical Skills: Expert-level mastery of Microsoft Excel (Power Query, Power Pivot, macros, data tables). Proficient with business intelligence software (Power BI or Tableau) and state-mandated reporting portals or enterprise accounting databases. [5]

Key Responsibilities

Strategic Forecasting & Scenario Modeling (35%)

Dynamic Planning: Build, maintain, and stress-test the LMHA's rolling multi-year financial forecasting models to ensure long-term fiscal health.
Pro-Forma Business Analysis: Develop ROI models, break-even analyses, and financial pro-formas to evaluate proposed clinical expansions, new satellite clinics, or telehealth initiatives.
Funding Scenario Planning: Construct predictive "what-if" models to assess the financial impact of changes to state contract allocations, regional Medicaid reimbursement rates, or clinical staffing levels.

State Reporting, Compliance & Fund Optimization (30%)

State Cost Reporting: Lead the compilation, analysis, and submission of mandatory state healthcare cost reports, ensuring accurate overhead and clinical cost allocations.
Contract Metric Tracking: Monitor and model state-mandated performance metrics (e.g., target population service caps, crisis response times, and utilization quotas) to protect state funding tranches. [1]
Audit Protection & Allowability: Review budget structures against state accounting guides to ensure all expenditures comply with uniform grant management standards and avoid funding clawbacks.
Public Funds Reconciliation: Partner with the accounting team to ensure local tax appropriations, state general revenue, and federal block grants are tracked within appropriate fund-accounting structures.

Clinical Revenue & Productivity Analytics (25%)

Revenue Cycle Partnership: Collaborate weekly with the Billing and Revenue Manager to extract Electronic Health Record (EHR) claims data, analyze payer-mix behavior, and forecast net patient revenue.
Clinician Productivity Modeling: Build dashboards evaluating provider utilization, time-allocation logs, cost-per-encounter, and revenue-generation benchmarks across clinical teams (e.g., Crisis, Adult, Child & Adolescent). [2]
Denial & Leakage Analytics: Track structural insurance and Medicaid denial trends to quantify lost revenue and identify process flaws within clinical documentation or front-desk collections.

Variance Reporting & Executive Data Visualization (10%)

Executive Dashboards: Design and distribute highly visual, monthly KPI dashboards for the CFO, clinic directors, and board members.

Monthly Variance Reviews: Lead the investigation of month-end budget vs. actual variances, proactively flagging structural spending abnormalities in personnel or overhead before they impact cash flow. [3, 4

Full Time

Great Benefits

Tyler

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