The Contract Management System Administrator is responsible for the daily oversight, maintenance and accuracy of SRHS’ contract management software to ensure the software accurately calculates expected payer reimbursement, nets down gross accounts receivables correspondingly and identifies payer payment discrepancies promptly.
The CMSA will effectively perform daily activities that work closely with the Health System Contracts Administrator (HSCA) and the Patient Financial Services (PFS) Recovery team to ensure all third-party payer contracts are implemented, updated and maintained in the contract management application in accordance with Southern Regional Health System requirements and established contract and regulatory parameters.
Additional responsibilities will include assisting the HSCA in preparation for contract negotiation by providing payer reimbursement analytical data and serving as the first tier contact for EOB and Denial Recovery Analysts’ questions regarding managed care reimbursement in order to optimize reimbursement and maximize cash recovery.
A major responsibility will be to accurately build and maintain payer contracts and/or reimbursement methodologies within SRHS’ contract management software solution and ensure software issues are promptly identified and resolved.
Collaborate and proactively communicate with the Revenue Cycle Team to enhance Appeal and Underpayment Recovery policies and procedures while strengthening operational workflows.
Perform daily system audits and balancing activities to identify and resolve interface issues and contract calculation errors.
Facilitate and lead internal contract review meetings with HSCA and PFS team members to confirm reimbursement accuracy before contracts go into production and start netting down accounts receivables.
Conduct user software testing during initial software implementation, upgrade and/or patch installation.
Work directly with Director of Revenue Cycle Operations to identify opportunities for operational improvement and take appropriate action.
Bachelor Degree preferred or minimum two years of experience utilizing contract management software in a healthcare or payer setting required. Pathways Contract Management, iMACS, and/or Meditech experience required.
Knowledge of and proficient in multiple reimbursement methodologies for institutional services.
Experience in Hospital Business Office including, but not limited to, Billing, Third Party Collections, Regulatory Compliance, and Cash Applications.
Demonstrable proficiency with MS Applications, Word and Excel.
Excellent written and verbal communication
Professional Appearance and Attitude