The specialty contracting representative reports to the VP Contracting & Network Development. This position is responsible for the development of managed care contracting activities for the transplant services as well as assisting in other hospital managed care contracting activities. This position oversees and manages the billing, accounts receivables and account payable representatives for MTP (Methodist Transplant Physicians) transplant contracting. This position will be the internal resource in transplant economics and market trends.
Your Job Requirements:
Bachelor's degree required. Masters preferred
Five plus year's financial analysis and modeling skills
Previous Transplant background or knowledge preferred
Strong negotiation skills
MS Office skills above average user required
Your Job Responsibilities:
Methodist Transplant Physicians (MTP) Daily Operations functions:
Supervise MTP transplant contract billing/accounts receivables staff.
Manage the day to day operations of MTP claims submission & account receivables and accounts payables.
Audit payments for proper reimbursement from payors as well as to MTP providers and conduct necessary follow up.
Transplant Contracting relationships:
Maintain current agreements and negotiate new agreements including Single Case Agreements (SCA's).
Stay current with latest developments, advancements, and trends in the field of transplantation issues.
Perform market analysis for potential contracting opportunities.
Perform analysis and provide recommendations of transplant contracting rates:
Collect and analyze data of financial impact of current agreements, potential agreements and recommend current process improvement of contracting changes.
Work with the legal department in contract review and preparation of other facility agreements.
Hospice specialty contracting analysis, review and development:
Research, audit, develop and negotiate single patient Letters of Agreement (LOA's) with host networks.
Respond as an internal resource for education of staff on latest information in specialty contracting.
Analysis to support hospital agreements for transplant services
Collect and analyze data of financial impact of current agreements, potential agreements and recommend current process improvement or contracting changes.
Assist leadership in identifying and analyzing the design of contracts, supportive data, costing and medical services, demographic information and other available research that affect the financial and service delivery viability of managed care.
Work with other departments for success:
Work with business office and transplant staff to assure correct billing and documentation is provided to payors in order to ensure proper payments.
Work with business office and transplant staff with any problems incurred while trying to receive payment for contracted services.
Work with transplant staff and physicians to assure that contracting opportunities are researched and developed in order for MDMC (Methodist Dallas Medical Center) patients to have access to transplant services at MDMC.
Methodist Health System