Healthcare Contracts Specialist

About the Company: Great opportunity! South Orlando healthcare company is looking for a Contracts Specialist to join their team asap. This will be a contract assignment.

Type: Contract

Pay: starting at $16 an hour

Schedule:  Mon-Fri can be 7:30a-4:00p or 8:00a-4:30p

Job Description:

  • Responsible for the Quality Review (QA) of all Contracts loads and updates
  • Conducts and leads monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team
  • Communicates with the Billing Center, Central Intake, and Locations regarding contract changes and/or updates including distribution of reference guides as required
  • Conducts/leads implementation calls regarding payer rule changes and/or updates with billing centers
  • Maintenance and administration of all Contracts including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts
  • Administration of contracts includes but not limited to a complete redline/review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
  • Participates and assists with the research and preparation of Request for Proposals (RFP) and solicitations as required Development of Quick Reference Guides (QRG’s) Hospice, Non-par and specified Managed Care Contracts including the development and maintenance of Government reference guides as required.
  • Research and analysis of department assigned adjustments and development of monthly trend and root cause reports - Monitors the release of solicitations daily and maintains a list of active solicitations within company database.
  • Maintains database of contracts within shared drive
  • Creates FOIA requests as appropriate
  • Research of competitor information
  • Conducts conference calls with payors as required

Requirements and Qualifications:       

  • Four year degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts.
  • Contracts experience in the medical industry working with HCPCS, CPT and ICD-9 Codes is preferred.
  • Knowledge of Healthcare Contract Language and the ability to read and interpret Contract requirements and guidelines is needed.
  • Paralegal training, education or 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:9928
 

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