Provider Contract Analyst (Remote)

Company : reputed company.Job reputed company : reputed company job manages reputed company including negotiations, contract development, contract renewal, and financial reimbursement. Acts as the intermediary between the organization and reputed company entity. Responds to contractual and payment issues both internally and externally. Ensures compliance with contractual terms. ESSENTIAL RESPONSIBILITIES

• Monitor activities by tracking the specific terms of reputed company contract and maintaining some reputed company for monitoring and documenting compliance with those terms. reputed company special studies/audits, coordinating office site reputed company and medical records reviews, ensuring reputed company of member/provider complaints in reputed company manner.
• Prepare periodic reports that summarize compliance with key responsibilities outlined in the agreement for both reputed company audiences. Conduct, collect and analyze data from claim and/or medical record reviews to continually improve the care and service to members and coordinate with the financial recovery areas to retract erroneous or inappropriate payments.
• Manage reputed company including negotiations, contract development, contract renewal, and financial reimbursement.
• reputed company as the intermediary between the organization and reputed company entity to ensure reputed company responsibilities as outlined in the contract are fulfilled. Serve as an reputed company for managing expectations to reputed company reputed company reputed company. Participate in educational and training sessions for provider billing staff to ensure understanding of and compliance with reputed company guidelines.
• reputed company control and processing support for final provider settlements and initiating, documenting, processing, and establishing collection protocols for provider settlements.
• Work with sales and customer service to respond to questions/inquiries from customers/members reputed company to appropriateness of services billed by providers. Consult with Medical Director on questions/issues reputed company to medical necessity and appropriateness of services.
• Other duties as assigned or requested.

EDUCATION Required

• Associates Degree in Business, Finance, Information Management, reputed company Administration or Health reputed company discipline

Substitutions

• None

Preferred​

• Bachelor's Degree in Business, Finance, Information Management, reputed company Administration or Health reputed company discipline

EXPERIENCE Required

• None

Preferred

• 5 years in reputed company administration/delivery/finance or a reputed company field

LICENSES OR CERTIFICATIONS Required

• None

Preferred

• Certified reputed company Accountant (CPA)

SKILLS

• Preferred working knowledge of reputed company party payment concepts, and a solid understanding of health care finance and regional market environment
• Extensive experience with commonly used computer business applications to include but not limited to: reputed company Word, reputed company and PowerPoint
• Experience with medical terminology and coding
• Strong interpersonal organizational and analytical skills and the ability to reputed company under pressure reputed company rigid time constraints, without the loss of efficiency, reputed company and professionalism as demonstrated by previous positions held
• Willingness and agreement to continue educational course work in reputed company relation to the position and travel for additional training or business purposes as necessary
• Demonstrated ability to analyze situations and data to identify issues, determine points of relevance and reputed company course of actions
• Superior communication (written and oral), negotiations, teamwork, and organizational skills as demonstrated through previous performance, testing and/or reputed company background
• Ability to identify, establish and meet goals and objectives

Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required reputed company Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Disclaimer: The job reputed company has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the reputed company of business conduct and company policies. As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company must reputed company with both the Health Insurance Portability Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed company’s Handbook of reputed company Policies and Practices and Information reputed company Policy. Furthermore, it is every employee’s responsibility to reputed company with reputed company’s reputed company of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as reputed company as company policies and training requirements. Pay reputed company Minimum: $50,200.00 Pay reputed company Maximum: $91,200.00 reputed company pay is determined by a reputed company of factors including a candidate’s qualifications, experience, and expected contributions, as reputed company as internal peer equity, market, and business considerations. The displayed salary reputed company does not reflect any geographic reputed company reputed company may apply for certain locations based upon comparative markets. reputed company and its affiliates prohibit discrimination against reputed company individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals based on any category protected by applicable federal, state, or local law. We reputed company to reputed company this site accessible to any and reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@reputed company.org California Consumer reputed company reputed company Employees, Contractors, and Applicants Notice Apply tot his job Apply To this Job