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Rates Configuration Coordinator

1 month ago

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Job Summary

MedPOINT Management is seeking a highly skilled Rates Configuration Coordinator to join our team. As a key member of our Rates Configuration team, you will be responsible for updating and maintaining provider dictionaries, vendor contracts, and fee schedules.

Key Responsibilities:

  • Learn and understand the end-to-end process of creation and maintenance of provider dictionaries and fee schedules based on contract terms.
  • Assign the appropriate fee schedules to providers, including exceptions to the primary fee schedule based on the terms of the provider's contract.
  • Audit EZ-CAP Providers/Vendor configuration (fee schedule, fee set assignments, etc.)
  • Create capitation tables to facilitate the capitation assignment to all associated providers.
  • Work closely with HIT and Finance to ensure the accuracy and maintenance of all provider capitation configuration.

Requirements:

  • 1+ years of Managed Care or Healthcare experience in Rate Configuration, Terms and Conditions, Reimbursement or Claims Auditing field.
  • EZ-CAP knowledge and experience required.
  • Thorough understanding of ICD-9, CPT and HCPCS codes, Medicare and Medi-Cal fee schedules, RVUs and ASA reimbursement.
  • Intermediate knowledge of medical terminology and ability to read and interpret contracts and/or contract summaries.
  • Intermediate-level in Microsoft Office Suite (Access, Word, Excel, PowerPoint, Outlook), Crystal Reports, SQL.

About MedPOINT Management:

MedPOINT Management is a large MSO in the San Fernando Valley, offering competitive salaries and benefits in a collaborative working environment.