Remote Payor Strategy Contract Coordinator

TridentCare; Clearwater (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

TridentCare is seeking a Contract Coordinator to oversee managed care contract administration across all lines of business. You will liaise with Sr.

Manager and Sales, analyze contracts for profitability, and ensure accurate implementation and payment auditing for each contract. You will maintain contract records, outline provisions, support the Reimbursement team, and communicate changes to internal departments.

Qualifications

• 3 years prior contracting experience.
• 4+ years in health care billing/accounting required.
• High School Diploma required.
• Experience with contract management software preferred.
• Comprehensive knowledge of managed care for non-government payor relations programs.

Responsibilities

• Manage the contractual process to ensure accurate completion through submission and prompt response of managed care proposals and/or other required payors’ paperwork.
• Will function as primary liaison for all regional payors as defined by the Sr. Manager.
• Maintain electronic copies of all signed contracts within the federal, state and local guidelines.
• Outline contract provisions including rate analysis for impact.
• Assist the Reimbursement team with non-government payor related audits and inquiries.
• Review and discuss proposals and responses with Sr. Manager for approval.
• Work with System Support to load and test fee schedules and new filing formats for field requirements as soon as the detail is requested and obtained.
• Document the terms, fee schedules, and other billing requirements for managed care payor contracts.
• Ensure that all fee schedules are updated and current based upon contractual “terms”.
• Communicate new and amended contracts to internal departments as necessary.
• Routinely audit processes to secure optimal status.
• Develop and execute contract documents which align with the annual strategy to ensure that the company’s goals and objectives are met.
• Prepare opportunity analysis for pricing determinations and opting for in-network/out-of-network managed care.
• Evaluate and monitor contracts to determine the overall profitability including renegotiating or terminating contracts if necessary.
• Maintain the payor’s participation listing of key contracts for billing and sales teams.
• By utilizing existing tools and working with the Billing Management Team, maintain and continue developing solutions to address payor/contract related issues.
• Identify possible problem payors/reimbursement trends negatively impacting cash collections.
• Educate internal and external clients/customers about any exceptional payer requirements.
• Pro-actively pursue payors for contracts based upon volumes, payments, collection percentages, sales team opportunities, and when payers are uninterested, renew angle with educational information to benefit the payor.
• Act as a liaison between Billing A/R team and payor relations when contractual related A/R issues escalated.
• Will perform other duties as assigned.

Skills

Communication

Payer dynamics

Contract negotiation

Time management

Attention to detail

Goal orientation

Multi-tasking

MS Office

Education

HS Diploma

Contracting experience

Healthcare billing

Contract management software

Managed care knowledge

Job description

TridentCare is seeking a Contract Coordinator to oversee managed care contract administration across all lines of business. You will liaise with Sr.

Manager and Sales, analyze contracts for profitability, and ensure accurate implementation and payment auditing for each contract. You will maintain contract records, outline provisions, support the Reimbursement team, and communicate changes to internal departments.