Medasource
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Position: PB HB Contracts Analyst
Location: Remote,
Duration: 6month CTH
Summary:
The PB HB Contracts Analyst is responsible for all loading, modeling, support, and maintenance of the contracts and fee schedules within the contract management system. This includes Federal and Managed Care contracts for all Health Systems entities; facility, professional, home care, infusion, pharmacy, etc. Provides key Revenue Cycle support and insight to Managed Care Office for contract negotiation considerations. This role supports implementation of new and upgraded systems/releases or new/revised operational procedures. The position includes the capability to model, support and operationalize contracting methodologies to understand and support payment variance analysis.
Functions
- Responsible for accurately and timely loading, testing, and maintaining all fee schedule and contract terms into the contract management system to maintain patient care and billing integrity.
- Assists with the analysis and resolution of payment discrepancies, and thoroughly tests and validates loaded contracts to effectively maximize both patient care and revenue cycle needs
- Completes the prospective modeling of proposed contracts, scenarios, and other changes potentially impacting reimbursement to support day to day operations and contract negotiations
- Proactively, or upon request, reviews contract performance, identifies improvement opportunities, and models impact for reimbursement review to inspire enhanced continuous improvement
- Generates periodic (monthly, quarterly, etc.) standard reports and surveys in accordance with the established schedule to stay abreast of market trends
- Analyzes, compares and determines the financial impact of Medicare/Medicaid/ TriCare and commercial fee schedule and contract changes and utilize the data to support managed care contract negotiations and variance discrepancies.
- Monitors contract-payment variances and supports leadership for addressing payment issues, and also maintains accuracy of expected reimbursement.
- Prepares and provides contract reimbursement summaries for department needs and identifies contract opportunities
- Responsible for modeling, loading, and testing EPIC contracts.
- Monitor federal and state regulations, interpret contract language and work with payer to ensure updates are provided timely.
Knowledge:
- Knowledge of and experience with the drafting of contracts and related negotiations, contract/case/document management systems and contracting strategies is required.
- Knowledge of the healthcare industry and applicable federal and state regulations.
- High level drafting skills for articulating ideas in a concise, specific, and straight forward manner and in a timeframe that supports a high volume of work.
- Excellent reading comprehension to discern and correct ambiguities and inconsistencies, and to ensure the intended meaning in conveyed in written documents.
- Exercise a high level of independent analytical and problem solving to develop contracting strategies to provide a competitive advantage to the hospital system for the purchase of healthcare equipment, products and services
- Possesses a working knowledge and understanding of managed health care contracts and have experience with contract modeling and contract management systems
- Possesses strong financial analysis skills and project management skills
- Candidate must have knowledge in hospital and professional charging and reimbursement.
Education:
Bachelor’s degree is required. Preferably in Business, Accounting, Finance, Health Care Management or associated field of study.
Certifications:
Required to have completed training and certification in these EPIC application modules – Resolute Hospital Billing Expected Reimbursement Contracts Administration, Resolute Professional Billing Reimbursement Contracts.
Work Experience:
· 5-8 years’ experience working in a decision support or financial analysis position with responsibility in a healthcare provider environment
· 3 years’ experience maintaining, updating, and loading EPIC contracts
PB HB Contracts analyst Baltimore, MD
For over 16 years, Medasource has established and maintained relationships that are designed to meet your IT staffing needs. Whether it’s contract, contract-to-hire, or permanent placement work, we customise our search based upon your company’s unique initiatives, culture and technologies. With our national team of recruiters placed at 21 major hubs around the nation Medasource finds the people best-suited for your business. When you work with us, we work with you. That’s the Medasource promise.
Medasource is an equal opportunity employer that does not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, lactation and related medical conditions), gender identity or gender expression, sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances.
Benefits & Perks:
Medasource offers competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage with plans that can fit each employee’s needs. We offer a 401k plan that includes a company match and is fully vested after you become eligible, paid time off, sick time, and paid company holidays. We also offer an Employee Assistance Program (EAP) that provides services like virtual counseling, financial services, legal services, life coaching, etc.
Pay Disclaimer:
The pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.
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