Mercy Health Contract Management Analyst in Mason, Ohio
Contract Management Analyst
Job ID: 4631646
Updated: August 18, 2016
Geographic Location: HomeOffice
Location: Mason, OH, United States
Department: Rev Cycle HO & Suppt Services
Full/Part Time: Full-Time
Standard Hours: 40
Scope of Responsibility:
Loads contract reimbursement terms into applicable contract modeling systems for all insurance claim payors.
The Analyst of Contract Management loads payor reimbursement terms into contract modeling systems and is responsible for the ongoing maintenance and validation of payment calculations for all payors across Mercy Health. Job duties include, but are not limited to, working closely with Managed Care and Revenue Cycle leaders to ensure correct contracts are loaded and validated for accuracy. Working closely with appropriate departments to make sure all payment calculation validations and contract maintenance needs are performed timely and accurately. Performing audits and analysis on the contract modeling system and ensuring contractual adjustments are taken according to the contract, and keeps current with industry knowledge of reimbursement trends and policies. They will perform these duties while meeting the mission and goals of Mercy Health ministry, as well as meeting the regulatory compliance requirements.
It is expected that all of the duties and responsibilities of this position will be performed in a manner consistent with the Ministry’s Standards of Behavior (CARE; Compassion: seeks to understand, listen and explain; Advocate: is the voice for the vulnerable; Respect: demonstrates the highest regard for and welcomes all people; Excellence: commits to the highest standard of quality care, joyful service, and teamwork) and in a manner that reflects the core values of Mercy Health which are: Excellence, Human Dignity, Justice, Compassion, Sacredness of Life and Service. All supervisors and above are expected to model the organizational mission and values through their daily actions, decision making and priority setting. All supervisors and above are expected to develop, implement and monitor short and long range plans to meet or surpass standards consistent with the overall strategic plan.
- Contract load/build, rate load validation, maintenance and analysis.
- Works closely with Payment Variance team to identify modeling issues and trends. Completes analysis on contract payment discrepancies and analyzes all questions related to contract load and calculation questions/issues.
- Performs other duties as assigned
- 4-5 years experience in healthcare.
- 4 year Bachelors Degree
- Combination of post-secondary education and experience will be considered in lieu.
- Experience in physician and hospital Revenue Cycle to include Payer Contracting, Payment Variance (underpayments) and compliance. High attention to detail.
- Experience in EPIC, PCON or Concuity modeling applications.
Shift and Job Schedule
Full-Time, 40 hours/week
Days, start and end time varies
Equal Employment Opportunity
It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.