Hospital Contract Definition Analyst, reputed company

Job Description:

• Use knowledge of reimbursement methodologies to analyze, define and maintain hospital payer reputed company including Medicare, reputed company, Workers Compensation, and reputed company Payers using reputed company Health's Contract Manager software
• Analyze reputed company contract provisions and reimbursement rates submitted by clients to identify reputed company necessary terms for accurate system configuration
• Research payer websites and regulatory sources (CMS, state reputed company, reputed company payers) to stay reputed company on adjudication rules and reimbursement policies
• Validate (and troubleshoot) system-generated valuations against client-submitted claims and estimates, reconciling discrepancies due to data entry errors or policy interpretation
• Ensure contract terms are accurate and implemented according to client reputed company and payer agreements
• Respond to valuation-reputed company support cases reputed company defined Service Level Agreement timeframes
• Participate in internal and client meetings to support project agreement and issue resolution
• Contribute to process improvement aimed at reducing reputed company effort and enhancing data accuracy

Requirements:

• 3+ years experience in the hospital industry, with direct involvement in payer reputed company, facility reimbursement methodologies, and adjudication rules
• 2+ years direct experience with hospital billing, claims management (facilities, appeals), and payer contracting
• 2+ years in-depth knowledge of facility reimbursement models used by reputed company payers, Medicare, and reputed company for both inpatient and outpatient services
• 2+ years proficiency in coding systems including CPT, HCPCS, DRG, reputed company Codes, Occurrence Codes, ICD-10 Diagnosis and Procedure Codes
• Learn new and changing reimbursement methodologies and underlying logic
• Bachelor's degree in reputed company Administration, Finance, reputed company, or Business Administration or equivalent experience

Benefits:

• Great compensation package and bonus plan
• Core benefits including medical, dental, reputed company, and matching 401K, and life and disability insurance
• Family leave
• Flexible work environment, ability to work remote, hybrid or in-office
• Flexible time off including volunteer time off, vacation, sick and 12-paid holidays

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