Category(s): Finance, Revenue Cycle
Full Time / Part Time: Full-Time
This position is responsible for accumulation, verification, and quality control of the Contract Management System. The incumbent performs analytical review of data for quality and completeness to insure proper payment is received from insurance companies. S/he will be responsible for validating that payer contracts are modeled correctly. S/he will analyze, summarize, and communicate findings and recommendations related to variance analysis and contract modeling. S/he possesses the technical skills needed to compile and manage data from numerous disparate information systems.
1) Analyze data in the Contract Management system to ensure that payer contracts are modeled correctly. Build and analyze variance reports.
2) Communicate problems with modeling and provide high level resolutions to the Contract Management Administrator. Open cases in the contract management client portal to report and work on the resolution of contract modeling issues.
3) Obtain and apply knowledge in the following Revenue Cycle Business Functions: Charge Capture, Coding, Billing, Denial Management, Insurance payment methodologies (including the associated IT systems) to support revenue cycle initiatives.
4) Produce multiple reports to support the Revenue Cycle. Work collaboratively with other Revenue Cycle departments to ensure proper follow up on insurance payments and contract payment policies.
5) Provide and communicate rate, contract and fee schedule updates to other Revenue Cycle applications.
6) Utilize multiple software applications to assist in research, including; Cerner Accounts Receivable, billing scrubber software, Craneware, document imaging repository and various payer websites.
Required Work Experience:
1) 5 years in hospital revenue cycle.
Preferred Work Experience:
1) None Listed
Skills and Competencies:
1) Excellent written and oral communication skills.
2) Excellent analytical skills and attention to detail.
3) Ability to prioritize multiple demands on time.
4) Proficient in Excel and possessing the aptitude to learn and work with different software applications on a regular basis.
5) Experience with Billing and AR followup procedures or Managed Care contracts preferred.
Bachelor of Science: Finance, GED or HiSET (Required)
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.