This position exists to analyze healthcare reimbursement contracts and then load contract terms between payers and providers in an accurate and timely manner using proprietary software. This position reports to the Director of System Integrity and will collaborate with the programming and development teams in the creation and vetting of calculation methods, database loads, or changes. In general, this position is an internal resource to staff and clients and as such is expected to respond to client issues and cases in a timely manner.
- Load contracts negotiated between payers and providers
- Maintain contract grid for clients and link contracts to payer products
- Claims: mapping to proper payer products, repricing and checking for errors
- Respond to client issues in a timely manner.
- Participate in client implementation planning, conference calls, meetings, and trainings
- Become knowledgeable about and responsible for internal controls and procedures for the position’s areas of responsibility
- Meeting internal or contractual deadlines. Accuracy is a key measurement
- Zero error rate will be a key indicator of success
- Claims accuracy. Staying current on application functions, features, and industry trends
- Client relationships that are extended or improved
- Contribute in ways that enhance company applications and increase the integrity of current client processes
- Adherence to established policies and procedures for internal control standards
Education and Work Experience:
- Bachelor’s Degree or equivalent work experience in Healthcare Revenue Cycle Management/Contracting field
Knowledge, Skills and Key Competencies:
- Strong working knowledge of health care reimbursement methods for Medicare, Medicaid, and Commercial contracts.
- Microsoft product proficiency. Must be an intermediate to expert user of Excel
- 1+ years, must possess strong analytical and math skills
- Requires excellent verbal and written skills.
- Detail orientated, organized, good problem-solving skills, entrepreneurial spirit
Protects and maintains patient and institutional information in a confidential manner and in a secured environment. Ensures data access limitations through the use of password protection, read-only access, and other measures that protect the data from unauthorized or accidental access.