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Managed Care Contract Analyst
3 months ago
Responsible to assist with obtaining new service contracts, maintaining current contracts and assessing financial impact of contracts through special price file development while ensuring the highest level of financial benefit for the organization in a corporate compliant environment.
Responsible to assist Managed Care Director with establishing and managing working contract relationships.
Maintains current knowledge of all business lines to include cost of service for contract participation and analysis and assists Managed Care Director with contract selection related to organization profitability.
Responsible to conduct and report payer analysis as directed on a quarterly basis, and report recommendations to support financial goals of the organizations.
Responsible to oversee special price file development to include review for accuracy, contract updates in a timely manner, as well as procedural developments.
Makes recommendations to the Managed Care Director supporting improvements and is a liaison to billing and collections programs.
Under direction of the Managed Care Director, maintains organizational notification for pending contracts completed and implemented.
Maintains current on knowledge of billing and collections procedures related to contract management.
Supports a positive team environment and exemplary customer service.
Education/Experience:
- High School Diploma required. Bachelor’s Degree in Business preferred.
- Experience with contract negotiation required.
- Knowledge of healthcare ancillary service business lines preferred.
- Knowledge of chargemaster and payer auditing procedures also strongly preferred.
- Experience with billing and collections requirements for Medicare and Third Party Payers required.
- Knowledge of HIPPA guidelines.
- Excellent verbal and written communication skills.
- Works well both independently and in a team environment.
- Knowledge of basic computer skills strongly recommended, Excel, Word and Access.
