Healthcare Insurance Contracts Specialist I

About the Company: Great opportunity! South Orlando healthcare company is looking for a Healthcare Insurance Contracts Specialist to join their growing team asap.

Type: Contract-to-Hire

Schedule:  Mon-Fri can pick set schedule options of 7:30-4, 8-4:30, 8:30-5 or 9-5:30 (1/2 hour lunch)

Job Description:

  • Review and analysis of Contract Quick Reference Guides submitted by the Managed Care Organization and interpreting payor rules and guidelines for appropriate set up in Contract and Item Master. 
  • Responsible for researching and analyzing daily Contract and/or Item master requests submitted by the billing centers and locations by reviewing Contract language, rules and pricing to ensure requested change is appropriate and within contract requirements. 
  • Responsible for analyzing each request to ensure proper claims submission via electronic or paper as well as correct payor requirements are applied (i.e. invoice vs. 1500 form, payor claim requirements, etc….) 
  • Performs daily maintenance and administration of Global Carrier codes (Claims Submission and Set Up) 
  • Responsible for the Maintenance and Administration of Medicare Competitive Bid Contracts 
  • Responsible for ensuring appropriate Contract to Global Carrier links to make certain the correct carrier/ contract link is set up so the appropriate payer rules and pricing are extracted

Requirements and Qualifications:       

  • Associate's degree or equivalent experience.
  • Contracts experience in the medical industry a huge plus.
  • Healthcare background highly preferred.
  • DME (Durable Medical Equipment), HCPC code or medical billing experience a huge plus.
  • Proficiency in Microsoft Office applications, including Basic Excel data entry.
  • Excellent written communication skills.
  • Meticulous attention to detail.
  • Thrives in a fast-paced environment.
  • Customer service focused.

 

Category:Administrative/Clerical
City/State/Zip:Orlando, Florida 32811
Job ID:11477
 

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