Position Overview
**Job Summary and Responsibilities**
Responsible for contract management, project management and associated reporting to support internal/external customers and assure compliance with state, federal and other regulatory agency requirements.
Maintains an understanding of the key elements of a payer contracts (commercial, Medicare advantage, Medicaid HMO), including reimbursement requirements.
Reviews contracts and makes recommendations to ensure standardization and consistency in payer agreements. ∙ Performs audits to validate payer compliance with contracts by using various standard reports, data integrity testing and claimreconciliation payment data. Identifies opportunities and makes recommendations to renegotiate contacts, in order to maximizehospital reimbursement levels.
Performs quality control measures on contract processes, including system setup, claim adjudication and payment reconciliation. ∙ Drafts contract documents and letters to payor...