Contract Management:

• Ability to research, analyze and communicate payer trends to identify reimbursement and training opportunities
• Ability to gather, analyze and refine complex data sets from a variety of Managed Care reimbursement methodologies and practices.  Ex: ICD-10, CPT/HCPCS, APR-DRG, DRG etc…
• Work with ancillary departments to resolve payer questions
• Expert communication skills to effectively address payer issues
• Ability to build, analyze and review financial impact for contract negotiations
• Ability to build contracts in the contract modeling tool
• Stay current with CMS Methodology through research and education sessions
  Information Management:
• Interpret data and analyze results to meet information and financial needs of the organization
• Excellent computer proficiency including experience with MS Excel functions that include vLookups, pivot tables, filtering and formulas to generate desired results
• Utilizes analytical tools to prepare reports (i.e. spreadsheets, graphs etc.)
• Coordinates the development, testing and implementation of tools owned or supported by the Managed Care Department
  Reporting:
• Develops databases for contract management (as needed/requested)
• Ensure report(s) are accurate and complete based on the requirements
  Communication:
• Work and guide payment resolution specialists in scope of work
• Effectively communicates with other departments, vendors and payers (as necessary)
  Customer Service:
• Work with Payors to develop and maintain a positive working relationship
• Work with other departments within the organization to coordinate and secure information needed
  Regulation:
• Adheres to NMHS/NMMC Policies/Procedures/Guidelines
• Complies with applicable Local/State/Federal procedures, guidelines, regulations and laws
  Requirements:
• Bachelor Degree in Business, Accounting or health related field or 2 years additional hospital experience.
• Minimum of 3-5 years’ experience in business, accounting, coding or revenue cycle; preferred
• Working knowledge of computer competencies in the following applications:  Programming, Database, Word Processing, Presentation Software, Spreadsheets, and Graphics; required
• Good written and verbal communication skills; required
• Excellent organizational, analytical, and creative thinking skills; required
• Knowledge of clinical terminology; preferred