Implementation Specialist
Emdeon - Tennessee

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  • Read, interpret and evaluate hospital contracts with Insurance Companies on the basis of language content, rates, terminology, and reimbursement methodology
  • Accurately write, categorize and submit analysis of hospital contracts for Coding translation into Contract Management Systems
  • Perform necessary contract link maintenance, updates and modifications associated with contract/amendment changes.
  • Execute rules testing to verify accuracy of written contracts
  • Screen Clients’ online systems for: published Payor Mix changes; new, modified and/or updated contracts/agreements/amendments, and fee schedule and/or table updates
  • Timely, assemble Clients’ Payor contracts and updates
  • Other duties as assigned
Job Qualifications:
  • Strong personal leadership and communications skills
  • Strong insurance company/hospital contract experience
  • Strong analytical and problem solving skills
  • Strong organizational skills
  • Ability to prioritize workload and flexibility to work on several projects at one time
  • Ability to work independently with minimal supervision
Skills Required:
  • Excellent contract interpretation skills including understanding of rates, amendments, reimbursement methodology, terminology, and strong comprehension of insurance industry process, procedures and limitations
  • Strong decision making and problem solving skills
  • Ability to multitask and set priorities
  • Knowledge of Medicare/Medicaid and Medicare/Medicaid HMO
  • Understanding of A/R projects procedures and process
Education, Certifications and Experience:
  • High school or high school equivalent
  • At least 3 years of related experience in hospital or Health Insurance company in Provider Relations, Contract Management, Configuration or other related Health Care Revenue Cycle functions

About this company
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Emdeon is a leading provider of revenue and payment cycle management and clinical information exchange solutions, connecting payers,...