Healthcare & Billing/Contracting Specialist
Company: Disability Solutions
Location: Port Saint Lucie
Posted on: May 4, 2024
Job Description:
ABC Medical is one of the nation's leading urological supply
providers, and serves as a one-stop shop with a comprehensive line
of medical supplies and service that includes: Urological,
Incontinence, Wound Care, and Ostomy. ABC Medical is part of the
JDS, Inc family of businesses. Our service companies possess the
knowledge and expertise to deliver first-class products and
personalized home healthcare services.Work Location: Remote
Candidates must reside in one of the following states: Florida,
Georgia, Virginia, Pennsylvania, Ohio, Tennessee, Alabama,
Illinois, Minnesota, Arkansas, Texas, Colorado, California,
Washington Hours: 8:30 - 5:00pm Local Time You Will
(Responsibilities): The Contract Administrator provides oversight,
management, coordination, organization, and communication of payor
contracting activities for each of the ABC Medical family of
companies. The Contract Administrator is responsible for
maintaining all company payer agreements, addendums, renewal terms,
and required notification or due dates. The position interprets all
payer requirements and ensures that those requirements are
systematically implemented in company operating processes. The
Contract Administrator manages the payer contract process and
collaborates with the sales team and internal departments to ensure
staff are informed of contracting status. Key factors include
supporting the sales growth by developing new contracts with payers
and expanding contract coverage to pursue profitable business
growth.
- Pursue, negotiate, and maintain contracts with all payers,
e.g., insurance companies, IPAs, TPAs and government programs.
- Understand insurance policies and regulatory guidelines to
implement systematic parameters to ensure compliance with
payer-specific rules and requirements.
- Provide expertise and support to internal departments regarding
specific payer guidelines and contractual inquiries.
- Understands and identifies profitability opportunities within
assigned payers.
- Facilitate the payer contracting process and ensure accuracy of
all contract documents from pre-contract through post-contract
phases.
- Works with legal, credentialing and all relevant involved teams
to ensure contracts are compliant.
- Provides contract summaries and ensure contract execution in
accordance with company policy.
- Supports providing a monthly report to senior management and
organizational stakeholders with progress and status of contracted
payor agreements.
- Supports the maintenance of a common provider
directory/database for enrollment with payers.
- Supports the research of territories to identify gaps in payer
base to support contract expansion.
- Assist with all contracting administration and projects, as
needed. Minimum Qualifications:
- Associate or bachelor's degree, or 5 years of relevant
healthcare contract experience
- Ability to interact professionally and ethically with team
members, all levels of management, government agencies, and
insurance payer personnel
- Ability to manage multiple tasks simultaneously in a fast-paced
environment
- Ability to provide clear, concise oral and written
communications
- Ability to handle special requests in a sensitive, professional
manner
- Strong attention to detail and follow through skills
- Meticulous organization and filing skills Preferred
Qualifications:
- Experience working at a medical insurance company, IPA, TPA
highly preferred
- Familiarity and experience with DME and/or Medical Supply
reimbursement, including Medicare, Medicare Managed, Medicaid, and
Medicaid Managed plans.
- Knowledge and use of Brightree software preferred but not
required.
- Advanced Microsoft Office experience
- Ability to troubleshoot complex payor events Here's what we
have to offer:
- Variety of Medical, Dental and Vision Insurance Plans
- 401k Plan with Company Match
- PTO and Paid Holidays
- EAP
- Employee Discounts Pay Transparency Statement: The anticipated
base salary range for this position is $55,190 - $102,496. The
actual salary varies based on applicant's location, education,
experience, skills, abilities, and other legitimate business
factors. The Company also provides a unique Benefit of Employee
Share Ownership Program (BESOP) program.
- The Company's health and welfare benefits include: medical,
prescription, dental, vision, spending/savings accounts,
disability, statutory leaves/disability programs, accident, life,
wellbeing, and voluntary benefit programs.
- The Company's 401(k) Retirement Savings Plan includes: vesting
and eligible participants "safe harbor" matching
contributions.
- The Company's paid time off benefits include: 8 paid holidays
and paid vacation based on length of service and exempt/non-exempt
status. To make life more rewarding and dignified for the people
who use our products and services.
Keywords: Disability Solutions, Tamarac , Healthcare & Billing/Contracting Specialist, Accounting, Auditing , Port Saint Lucie, Florida
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