Contract Management Analyst

1 month ago

Franklin, United States SSC - Nashville Full time

(Full Time, Remote)

The Analyst is responsible for accurately coding, testing and maintaining managed care contracts from assigned facilities into the contract management system in conformance with the language of the legal document. The Contract Analyst also works with expression building tools and with the Programming Administrator to extend the capability of the system to handle new service definitions and reimbursement methodology. The Contract Analyst acts as a liaison for Managed Care Financial Analysts modeling contracts and other financial managers in understanding calculations produced by the contract management system.

As a Contract Management Analyst at PCCM/CHS Shared Service Center - Nashville, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including health insurance, flexible scheduling, 401k and other elective benefit programs.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Load ("programs") executed managed care contracts into the contract management system
  • Update contracts with scheduled rate changes as of effective dates
  • Build new service definitions and implements new reimbursement methodology into the system as required
  • Consult with contract negotiators to recommend precise language and meaning of contracts to ensure that the contract template accurately calculates the terms of the contract as negotiated
  • Monitor periodic changes in recognized coding schemes (ICD, CPT, and DRG) to anticipate impacts on contract language, calculations and reimbursement of specific contracts using those codes
  • Performs other related duties as assigned or requested
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

KNOWLEDGE, SKILLS, AND ABILITIES
  • Highly organized
  • Initiative to work independently
  • Ability to define problems collects data, establish facts, and draw valid conclusions
  • Proficient with telephone and email communications
  • Basic understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form, including: ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue code structures
  • Interest and aptitude in computer-based applications for complex business processes involving Boolean expressions,
    symbolic representation and procedural logic
  • Required PC competencies including intermediate Microsoft Office skills
  • Excellent interpersonal skills required to communicate with direct staff and internal/external customers
  • Must possess excellent time management and organizational skills with great attention to detail
  • Maintain applicable continuing education requirements
  • The ability to work on multiple projects/initiatives at a time
EDUCATION/EXPERIENCE
  • High School graduate or equivalent
  • Minimum of 1 (one) year of hospital revenue cycle experience or equivalent work experience


We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.

Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

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