Contract Review Analyst

United States·LargoNormalmid

Other

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Quick Summary

Overview

This employee reviews payor contracts and information associated to contractual obligations including payor fee schedule changes and posted policy updates for various payors.

Technical Tools

Other

This employee reviews payor contracts and information associated to contractual obligations including payor fee schedule changes and posted policy updates for various payors. They will work with Managed Care Contract Administrators, Payor and Price Table Team, and other required departments to ensure that policy guidelines and changes are updated accordingly and timely.

JOB FUNCTIONS

Contacts payors at times to discuss policies and/or changes
Documents payor requirements according to their policies as well as payor changes and relays changes to the appropriate departments
Pursues, maintains, and communicates medical guideline changes
Helps facilitate interoffice communication on payor updates and changes
Works with the Payor and Price Table team to ensure that policy changes are updated accordingly
Works assigned payors accordingly and timely
Available to assist other members on the team with questions and/or needs
Answers payor policy questions accordingly
Assists in identifying payor changes that need to be addressed
Works with BIS, payor, and price table group to ensure that payor policies are followed and updated accordingly to payor guidelines once changes have been identified
Communicates with the payor regarding policy information
Assists with the delivery directives from Corporate office as they apply to policy changes and/or updates

Education

High School Diploma or General Education Degree (GED) Required

Knowledge, Skills, and Abilities

Knowledge of the medical field preferred
Basic computer skills
Positive and cooperative attitude in working and communicating with individuals at all levels of the organization
Write reports, business correspondence, and procedure manuals
Effectively present information and respond to questions from groups of managers, clients,
customers, and the general public
Telephone etiquette alongside adequate oral and written communication skills
Shows effective multitasking skills