Coord. PFS Contracts-Patient Accounting

About the role

The Managed Care Contracts Coordinator reports to the PFS Manager and uses a contracts management system to develop and implement contract reimbursement models according to executed managed care contract terms. The role identifies and analyzes discrepancies in system and managed care reimbursement term calculations and performs reconciliation of payment variances. The Coordinator serves as an intermediary with Managed Care, Revenue Cycle, and PFS management to accurately administer contract terms, identify issues, recommend solutions, and implement resolutions necessary for timely and accurate reimbursement.

Responsibilities

• Develop and implement contract reimbursement models based on executed managed care contract terms.
• Identify and analyze discrepancies in system and managed care reimbursement term calculations.
• Reconcile payment variances to ensure accurate reimbursement.
• Act as an intermediary between Managed Care, Revenue Cycle, and PFS management to administer contract terms.
• Identify, recommend, and implement issue/problem resolution to support timely and accurate reimbursement.

Requirements

• Ten-key by touch required.
• Knowledgeable of Patient Management and Patient Accounting systems.
• Ability to deal tactfully with Network Representatives, Managed Care Director, Associates, and the general public.
• Analytical ability to comprehend, interpret, and explain complex contract terms.
• Strong financial analytical skills.
• Strong oral and written communication skills.
• Detail-oriented with the ability to set and meet deadlines and support multiple projects.
• Solid decision-making skills.
• Ability to work independently as well as in a team environment.
• Skilled in knowledge of computers and accounting systems.
• Proficiency with Microsoft Excel, Word, Access, PowerPoint, and time management skills.

Qualifications

• Minimum of 2 years of experience in a healthcare business office or related field required.
• One year of experience with claims processing and third-party reimbursement and managed care contracting preferred.
• Bachelor’s degree in Business or Healthcare-related field required.