Medical Bill Negotiator (On-Site)

About the role

The OccuNet Company is an innovative healthcare cost-containment organization committed to improving access to affordable, high-quality healthcare. We pride ourselves on an outward-mindset culture that values empathy, respect, and seeing one another as whole people. Our team thrives in a fast-paced, growth-oriented environment where continuous learning and collaboration drive our success.

Responsibilities

• Maintain great communication with your team, your team lead, as well as providers and clients.
• Own the end-to-end negotiation-from initial call to considering concerns of the provider and the client, ensure timing follow-ups, documentation and clear thought process.
• Be open to coaching even after training, and difficult conversations with providers to find ways to maintain relationships and great discounts.
• Identify and act on opportunities to grow Alliances by actively identifying providers with multiple single case agreements and referring them to the Alliance team.
• Rigorously approach complex negotiations of reimbursement rates, payment structures, and term changes to maintain and build best-in-class single case agreements with providers.
• Facilitate and initiate enhancements to contracting and negotiation processes for single case agreements.
• Provide direction and assist in developing national and local network strategies by identifying value-capture opportunities.
• Collaborate cross-functionally with internal and external stakeholders to improve internal systems and procedures to meet client needs.

Qualifications

• High school diploma or equivalent required.
• Associate or bachelor’s degree preferred.
• 2 years or more years’ experience negotiating single case agreement terms and rates either in value-based contracting or reference-based contracting with hospitals, provider groups, or ancillary medical providers (preferred).
• Experience developing and managing hospital or provider group relationships and instituting partnerships (preferred).

Skills

• Deep expertise in hospital, ancillary, and professional reimbursement rate for single case agreements across all lines of business.
• Foundational understanding of medical cost containment products including but not limited to reference-based pricing, out-of-network, and pharmacy benefits manager solutions.
• Knowledge in medical billing including CPT and ICD 10 coding.
• Deep contracting and negotiation skills, including but not limited to contract preparation and implementation, financial analysis, and rate proposal development.
• Knowledge of provider groups in geographic areas as well as interrelationships across the competitive landscape.

Benefits

• 401(k) with matching
• Dental insurance
• Health insurance
• Vision insurance
• Health savings account
• Paid time off