Clinical Budgeting Specialist

🔥 21 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💸 Financial Planning and Analysis (FP&A)

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Paradigm

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1991

☁️ SaaS

🔥 Funding within the last year

💰 Private equity on 2025-08

SaaS

Paradigm is a company whose publicly accessible web application returned only the message: "Loading application... Your web browser must have JavaScript enabled in order for this application to display correctly. " No additional information about its products, services, or market focus was available from the provided content. Based on the presence of a web application but lacking further details, no definitive product, sector, or clientele can be determined from the supplied input.

📋 Description

• Serve as a resource for Paradigm Clinical Management staff as it relates to financial liability for all provider services and other Contract-related costs. • Partner with Director Clinical Solutions to manage the development of all new Contract budgets. • Research and document patient driven costs and provider rates that drive budget development and management. • Complete all Provider Rate Negotiation (PRN) requests to include accurate documentation of known or estimated financial liability in the system. • Develop relationships with providers, including preferred provider organizations (PPOs), hospitals and specialty providers. • Maintain current knowledge of regulatory, industry and contractual factors to ensure the accurate estimation of Paradigm’s liability. • Collaborate with other internal departments to address and resolve specific patient/provider issues. • Analyze contract budget to actual to evaluate clinical requirements and develop action plans. • Work with the Risk Analytics Team to determine trends and identify improvements that can be made to enhance the accuracy and ease of budget development and/or forecasting. • Utilize AI tools to support day-to-day tasks and adopt new technologies as trained.

🎯 Requirements

• Bachelor’s Degree in health care administration, business, finance or related field • A minimum or combination of five years of experience with demonstrated success in health care or related field. • Medical coding certification preferred • Medical billing in workers compensation industry preferred • Prior experience reviewing medical documentation and assigning CPT codes to determine workers’ compensation fee schedule reimbursement. • Must maintain current understanding of state regulations and their impact on medical care and reimbursement in the workers’ compensation care market. • Strong medical background to include comprehensive understanding of medical terminology and health care principles and practices. • Demonstrated ability to multi-task in a fast-paced work environment, assess importance of activities, and adjust priorities when appropriate. • Experience with various computer applications including Microsoft Office, Outlook, Word and Excel. • Excellent oral and written communication skills; able to make presentations to audiences of varying levels, size, nature and backgrounds. • Demonstrated ability to analyze difficult situations, problems and data and develop feasible and effective solutions. • Any combination of education, experience and knowledge that demonstrate the ability to perform the functions of the position will be accepted.

🏖️ Benefits

• Health insurance • Flexible work arrangements • Professional development