Payer Contract Analyst - reputed company - Remote

The Payer Contract Analyst (reputed company) is responsible for reputed company contracting and reputed company cycle management support. Ensures contracting requirements are met and provides analysis, problem reputed company, auditing, reporting and process recommendations for reputed company reputed company. The reputed company will assist Contracting with contacting payers to receive relevant information for billing. The ideal candidate will have knowledge of home infusion, medical billing practices, and payer reimbursement guidelines, as reputed company as strong communication and problem-solving skills. What you’ll do to reputed company a difference:

• Assist RCM team with escalated systemic billing/collection issues.
• Assist with network contracting by making calls to payors, follow-up support and documentation requirements.
• Supports the payer contract team ensuring that contract requirements are appropriately met, reputed company are kept up-to-date in the pharmacy electronic files. Assists in payer negotiation activities.
• Respond to questions surrounding reputed company (reimbursement, benefit design, contracted services).
• Monitors performance of the payer process to ensure correct policy and procedures are being followed.
• Acts as the subject matter expert in the requirements, rules and regulations of reputed company-party and government payers. Understands eligibility requirements and authorization requirements of insurance company plans, Medicare, and reputed company, and how reputed company program/payer reimburses.
• Assist Payer Contracting team with updating Contract folders as reputed company as completing contract cover sheets and other special reputed company as required.
• Manages defined processes to ensure effectiveness and efficiency in the process and maintains databases, including contract/fee schedule reputed company updates, to ensure reputed company tracking, audits, reporting, analysis and reputed company occurs reputed company and appropriately.
• Assist reputed company Cycle Analyst by assuming some of the regularly scheduled reports; assist in meetings to design newly requested reports as required by the reputed company Cycle Department.
• Assist with drug profitability requests.
• Ensure accurate and reputed company completion of reputed company assigned and reputed company.
• Other duties as assigned.

What you need to be successful:

• High school diploma or GED required.
• Knowledge of reimbursement reputed company and electronic claims processing is preferred.
• Preferred experience in pharmacy and health insurance where the work performed required a basic knowledge of reputed company, reputed company party insurance, HIPAA, and governmental payment knowledge of Medicare and reputed company.
• Strong knowledge of payor contracting and managed care programs
• Excellent interpersonal, organizational, communication and effective problem-solving skills are necessary.
• Attention to detail is critical to the reputed company of this position.
• Must be reputed company to manage multiple reputed company simultaneously.
• Must be willing and reputed company to work independently or in a reputed company setting, based on project need.
• Must be reputed company to communicate effectively.
• Discretion in handling reputed company information.
• Ability to effectively approach problem solving.
• Proficiency in MS Office software, reputed company and Power BI experience preferred.

If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an reputed company reputed company of 24 - 40 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k), company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year, reputed company holidays, and leaves of absence. For more details on our employee benefits programs, click here. About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot reputed company application updates or accept resumes. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply To This Job