Contract Specialist - Managed Care
St. Peters Health Partners - Albany, NY

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St. Peter's Health Partners in Albany, NY is seeking a Managed Care Contract Specialist . St. Peter's Health Partners has over 12,500 employees in more than 165 locations!

The Managed Care Contract Specialist serves as a key control to ensure St. Peter's Health Partners is properly reimbursed for the patient care services it provides, this position is responsible for monitoring the financial performance of managed care contracts and other reimbursement arrangements with third-party payors of the Hospital.

Key responsibilities and tasks include:
  • Serve as an expert on the financial terms of managed care contracts and other reimbursement arrangements with third-party payors.
  • Ensure accurate modeling of managed care reimbursement
  • Function as a liaison between the Reimbursement and Patient Accounting departments regarding payment discrepancies and required follow-up actions with third-party payors.
  • Perform daily monitoring of variances between modeled reimbursement expectations and actual payments.
  • Interact with third-party payor representatives on a regular basis to gain a shared understanding of the reimbursement expectations of contracted payment terms and tracking and monitoring of payment corrections.
  • Represent the Hospital's interests in meetings with third-party payors to resolve payment discrepancies
PREQUISITES:
  • Bachelors Degree in Accounting or Finance preferred.
  • Five or more years of relevant financial experience preferably within the healthcare industry.
  • Demonstrated competency with Microsoft Office with specific proficiency in MS Excel and MS Access emphasized.
Complete online application at www.sphcs.org/jobs .

Monster - 11 months ago - save job - block
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