Virtual Contract Analyst

HCA Nashville , TN 37201

Posted 7 days ago

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

  • Model managed care contract payment terms using ClearContracts

  • Review, create and maintain ClearContracts master files including global service descriptions, service rules, global fee schedules, profiles and hierarchy profiles

  • Complete appropriate Sarbanes Oxley workflow steps within the Calc Engine of ClearContracts

  • Complete testing of contract models by service line and keep documentation of accuracy in the Documentation & Compliance Module of ClearContracts

  • Upload and attach all pertinent contract documentation related to the rate schedules within the Documentation and Compliance Module of ClearContracts

  • Complete and maintain the "Legal Options" section on the Documentation & Compliance tab

  • Coordinate with IT&S Reimbursement Product Support for the modeling of Government or other contracts modeled directly in the Payment Calculator System for contract effective periods prior to ClearContracts implementation

  • Provide the Shared Service Center Modelers with support for model updates using existing tools during the ClearContracts transition period

  • Provide educational resources to support contract implementation and administration

  • Liaison with Managed Care Services Group and Payors to address managed care contract administration issues related to Governmental, National or Global Models

  • Coordinate managed care contract implementation activities with the Managed Care VP's, Managed Care Services Group and the functional managers within the Shared Services Center

  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement"

  • Other duties as assigned

KNOWLEDGE, SKILLS & ABILITIES

  • Communication - communicates clearly and concisely, verbally and in writing

  • Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations

  • Interpersonal skills - able to work effectively with other employees and external parties

  • PC skills - demonstrates proficiency in Microsoft Office applications and others as required

  • Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems

  • Basic skills - able to perform moderately complex mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately

  • Excellent oral and written communication skills

  • Self motivated

  • Able to work independently and as a team member

  • Analytical

  • Detail oriented

  • Excellent PC skills including experience with Microsoft Office and Excel

  • Excellent people skills

  • Management skills

  • Organizational skills

EDUCATION

  • Undergraduate degree required

EXPERIENCE

  • Minimum 3years HCA experience preferred

  • Proven ability to manage project work

  • Required understanding of medical finance, managed care contracting, or business office/claims shop operations

  • Working knowledge of managed care contracting and modeling preferred

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Virtual Senior Appeals Analyst

HCA

Posted 1 week ago

VIEW JOBS 3/13/2019 12:00:00 AM 2019-06-11T00:00 Parallon believes that organizations that continuously learn and improve will thrive. That's why, after more than a decade, we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry's leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services. We are looking for a dynamic candidate to be part of our team. We offer excellent benefit packages, including 401K, bonus potential, tuition reimbursement, medical and dental plans, flexible spending plans, long-term/ short -term disability, and generous paid time off! DUTIES INCLUDE BUT ARE NOT LIMITED TO: * Review technical and clinical denial arguments for reconsideration on top dollar accounts, including both written and telephonically through resolution process. * Identify contract protection that can be leveraged to overturn denials * Identify coding or clinical documentation issues and work to correct the errors in a timely manner * Serves as a subject matter expert in payer appeals resolution process * Identify problem accounts/processes/trends and escalate as appropriate * Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument. We are in need of an experienced Senior Appeals analyst. This position research and resolve high dollar technical and top dollar clinical appeals through concise understanding of payer contract language and clinical or technical justification. You need the following to be our top candidate: * Bachelor's degree required * Master's degree preferred * 2 year of related experience required HCA Nashville TN

Virtual Contract Analyst

HCA