Senior Contract Management Coordinator

JOB DESCRIPTION

Job Title: Senior Contract Management Coordinator Reports To: Vice President of RCM FLSA Status: Non-Exempt Employment Status: Full-time

Effective Date:

______________________________________________________________________

Position Summary:

Perform a variety of administrative, clerical and analytical tasks to support Managed Care/Payer Contracting team with the management of health plan contracts and associated fee schedules, including integration with new practices and maintenance of fee schedules and contracts for company systems.

Duties and Responsibilities:

• Work with payer contracting team to manage health plan agreements in the contract management system, including storage of all payer agreements, amendments and associated fee schedules.
• Set up practices’ health plan contracts in contract management system and fee schedules in company systems.
• Outreach to health plans and use payer portals to ensure all agreements are accessible with current, historical and updated fee schedules including Medicare, Medicaid, Tricare, Commercial, etc.
• Provide updated health plan policies and rates to payer contracting and RCM analysts to model financial impact and updating in company systems.
• Create reports and secure industry data to determine net effects of growth initiatives across the company including geographic and service expansion.
• Support renegotiation as needed and evaluate need for renegotiations annually.
• Perform comparisons of rates across states and within existing markets to provide support renegotiations and support integration.
• Assist in management of National Agreements, both related to delegated credentialing and reimbursement.
• Prep presentations for leadership related to payer contracting trends as needed.
• Payer/provider relations related to contract related issues and provider enrollment issues.
• Communicate effectively with payer contracting, credentialing, RCM and other teams as needed.
• Perform other work-related duties as assigned.

Education: High School Diploma required and college or paralegal certification preferred.

Skills/Experience:

Required

• Knowledge of medical billing/collection and/or insurance agreements.
• Excellent written and verbal communication skills
• Flexible, organized, and self-motivated
• Working knowledge of office equipment, like printers and fax machines
• Proficiency in MS Office (MS Excel, PowerPoint, Outlook, etc.)
• Ability to work under pressure and remain friendly and professional
• Excellent time management skills and the ability to prioritize work
• Attention to detail and problem-solving skills
• Typing speed in excess of 50 wpm
• Comfort level with basic math, comparisons of rates and percentages using excel
• Strong organization skills with the ability to multi-task
• High School diploma required
• Customer service and previous administrative experience is a definite plus

Preferred

• Some College or Paralegal Certification
• Experience reviewing agreements between insurance companies, networks or MCO’s (payers) and health care provider groups from either the payer or provider perspective
• Provider or payer relations or credentialing experience

Physical Demands: use the words regularly, frequently and occasionally.

• Sitting and standing associated with a normal office environment.
• Manual dexterity needed for using a computer keyboard.
• Regularly required to talk and hear.
• Frequently is required to use hands or finger, handle, or feel objects, tools or controls.
• Occasionally required to stand, walk, sit, reach with hands and arms, climb or balance, and stoop, kneel, crouch, or crawl.

Note:

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills aptitudes and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.