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Reimbursement Contract Specialist

4 months ago

Frisco, United States Soleo Health Inc Full time
Job DescriptionJob DescriptionDescription:

Soleo Health is seeking a Reimbursement Contract Specialist to work Remotely (USA) with our Payor Contracts. Home Infusion experience required. Join us in Simplifying Complex Care


Soleo Health Perks:

  • Competitive Wages
  • Paid Parental Leave Options
  • 401(k) with a match
  • Great company culture
  • Referral Bonus
  • Annual Merit Based Increases
  • No Weekends or Holidays
  • Affordable Medical, Dental, & Vision Insurance Plans
  • Company Paid Disability & Basic Life Insurance
  • HSA & FSA (including dependent care) options
  • Paid Time Off
  • Education Assistant Program

The Position:

The Reimbursement Contract Specialist supports Reimbursement Contract Management with research throughout the payor contract review process and in addition, provides guidance/trainings to stakeholders on existing and new payor contract information. This requires management of internal resources pertaining to contract reimbursement information within the company intranet site and a high level of written and oral communication with a broad range of stakeholders.

  • Assists Reimbursement Contracts Manager in review of payor contracts and amendments.
  • Provides consultation, education and training on payor contract requirements to Intake and Reimbursement teams.
  • Provides timely and accurate information regarding payor reimbursement methodologies, rates and policies to stakeholders.
  • Manages payor contract, reimbursement related resources and other payor-related documents on company intranet site.
  • Prepares reports and assists with special projects.
  • In collaboration with leadership, investigates payment variances for payor contract non-compliance.


Schedule:

  • Typical business hours, 8:30-5p
  • Remote
Requirements:
  • At least 4 years of experience with Home Infusion therapies and associated HCPC codes
  • Must have experience with and thorough understanding of Payor Contracts (e.g. for audits, rate review/negotiation or reimbursement language review)
  • Reimbursement experience (RCM related): Auditing/root cause analysis, financial analysis, Home Infusion billing (medical) or similar
  • Advanced knowledge of medical insurance plans: Managed Care Organizations, Commercial, Medicare Advantage, Self-Funded, TPAs and providers at financial risk (hospital/health systems, medical group/IPA)
  • Experience in creation of training material or procedures (SOPs) with ability to disseminate information regarding newly executed contracts to large groups
  • Advanced knowledge of Home Infusion or Medical Specialty Pharmacy pricing/fee schedules
  • High level of organization required, with proficiency in the Microsoft suite of products


About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference


Soleo’s Core Values:

  • Improve patients’ lives every day
  • Be passionate in everything you do
  • Encourage unlimited ideas and creative thinking
  • Make decisions as if you own the company
  • Do the right thing
  • Have fun

Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture.


Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Keywords: contract specialist, contract administrator, contracts manager, reimbursement specialist, auditing, analyst, contract, payor, negotiater, training, billing specialist, intake manager, clearance manager, lead

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