Contract Specialist

4 days ago


Franklin TN, United States Centralized Allocations Full time

Job Summary

We are seeking a skilled Contract Analyst to join our team at Centralized Allocations. The successful candidate will be responsible for translating managed care terms and model relevant parameters in Concuity/Clear Contracts Calc Engine to ensure accurate discounts on patient accounts and proper reflection of expected net revenue.

Key Responsibilities

  • Model managed care contracts through the Concuity Calc Engine
  • Perform ad hoc analyses as assigned by departmental Director, Manager and Team Leads
  • Perform Peer to Peer (Independent Review) for model changes related to rates or factors
  • Complete testing of contract models by service line and keep documentation of accuracy in permanent calc engine workflows
  • Work with senior members of the department, develop a responsive relationship with customers emphasizing timeliness and accuracy
  • Participate in departmental training and professional development opportunities when available
  • Add value to Parallon Contract Modeling by producing accurate results, working efficiently, and continuing to grow in the position

Requirements

  • College undergraduate degree preferred
  • Minimum of 1-3 years of experience preferred
  • Working knowledge of managed care contracting and modeling desired

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

Across HCA Healthcares more than 2,000 sites of care, our nurses and colleagues have a positive impact on patients, communities and healthcare. Together, we uplift and elevate our purpose to give people a healthier tomorrow.


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