Contract Review Analyst

About the role

This employee reviews payor contracts and information associated with contractual obligations, including payor fee schedule changes and posted policy updates for various payors.

Responsibilities

• Contacts payors to discuss policies and/or changes.
• Documents payor requirements according to their policies, as well as payor changes, and relays changes to the appropriate departments.
• Pursues, maintains, and communicates medical guideline changes.
• Helps facilitate interoffice communication on payor updates and changes.
• Works with the Payor and Price Table team to ensure that policy changes are updated accordingly.
• Manages assigned payors in a timely manner.
• Assists other team members with questions and/or needs.
• Answers payor policy questions accordingly.
• Assists in identifying payor changes that need to be addressed.
• Works with BIS, payor, and price table groups to ensure payor policies are followed and updated according to payor guidelines once changes are identified.
• Communicates with payors regarding policy information.
• Assists with directives from the Corporate office as they apply to policy changes and/or updates.

Requirements

• Works with Managed Care Contract Administrators, Payor and Price Table Team, and other required departments to ensure policy guidelines and changes are updated timely.