Job Description : Follow the Leader in the Home Healthcare Industry!
Rotech Healthcare Inc. is seeking a Contract Specilaist to join the Contracts Administration team. In this position you will be responsible for the maintenance and administration of both Contracted and Non-Contracted Payers that Rotech provides service for including Managed Care, Government Contracts, Hospice, Skilled Nursing, Professional Service Agreements, Patient Pay Agreements and Rotech’s retail pricing contracts. In this position you will also be responsible for the complete review and redline of payer polices and procedures including provider manuals, contract language and requirements to ensure Rotech compliance and contract performance.
- Maintenance and administration of all Contracts Rotech provides service for including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts
- Administration of contracts includes but not limited to a complete redline/review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
- Participates and assists with the research and preparation of Request for Proposals (RFP) and solicitations as required.
- Development of Quick Reference Guides (QRG’s) for Hospice, Non-par and specified Managed Care Contracts including the development and maintenance of Government reference guides as required
- Research and analysis of department assigned adjustments and development of monthly trend and root cause reports.
- Participation in Contact implementations and payer in-services
- Review and analysis of Contract Quick Reference Guides submitted by the Managed Care Organization and interpreting payor rules and guidelines for appropriate set up in Contract and Item Master. Analysis includes but is not limited to a quality review of Contract Plan type and Class for accurate revenue tracking, payer rules to include prior authorizations, cap rental rules and appropriate document requirements which all contribute to held item and adjustments
Job Requirements :
- Minimum of five years directly-related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes.
- Knowledge of Healthcare Contract Language and the ability to read and interpret Contract requirements and guidelines
- Four year degree or equivalent combination of college education and/or related work experience in healthcare, billing, and / or industry contracts.
- Paralegal Certificate desired
Make the right move, Contact us today! This application process will take approximately 15-20 minutes to complete. The hiring manager will review your resume and contact you if your qualifications match our needs. We appreciate your interest in Rotech Healthcare Inc.
- Competitive Compensation
- Career Path and Management opportunities
- Health and wellness benefits to include medical, prescription, dental and vision plans, short term and long term disability, supplemental life insurance and flexible spending accounts
- Employee Assistance program
- PTO and paid holidays
- 401K with company match
- Employee Discounts
- Employee Referral program
- Employee Recognition program
- Employee Service Program
Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees
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