Payor Strategy Contract Coordinator

🕒 3 dias atrás

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TridentCare

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

🤝 B2B

Healthcare • B2B

<TridentCare> TridentCare é um provedor nacional de serviços de saúde diagnósticos móveis e in loco, oferecendo serviços de raios-X digitais, ultrassonografia, eletrocardiograma (ECG), laboratório/flebotomia e acesso vascular (PICC) diretamente aos pacientes em instalações de cuidados especializados, residências assistidas e hospice, ambientes domiciliares, instalações correcionais/comportamentais, agências governamentais e locais comerciais. A empresa enfatiza profissionais licenciados e certificados, acreditações regulatórias rigorosas (ACR, CLIA, CAP, COLA) e fluxos de trabalho habilitados por tecnologia por meio de suas integrações TridentConnect EMR e plataformas certificadas HITRUST para otimizar diagnósticos e proteger dados dos pacientes. A TridentCare colabora principalmente com provedores de saúde e agências para expandir o acesso, melhorar a eficiência operacional e manter a continuidade do cuidado.

Descrição

• Manage the contractual process for managed care proposals, letters of interest, and payor paperwork • Serve as the primary liaison for regional payors • Maintain electronic copies of signed contracts in accordance with federal, state, and local guidelines • Outline contract provisions and analyze rate impacts • Assist the Reimbursement team with non-government payor audits and inquiries • Review proposals and responses with the Sr. Manager for approval • Work with System Support to load and test fee schedules and new filing formats • Complete and disseminate Health Plan Contracting Announcement Forms • Document contract terms, fee schedules, and billing requirements • Ensure fee schedules remain current based on contractual terms • Communicate new and amended contracts to internal departments • Routinely audit processes to secure optimal status • Develop and execute contract documents aligned with annual strategy and company objectives • Prepare opportunity analyses for pricing and in-network/out-of-network decisions • Evaluate and monitor contract profitability, including renegotiation or termination when necessary • Maintain payor participation listings for billing and sales teams • Develop solutions for payor- and contract-related issues with the Billing Management Team • Identify problem payors and reimbursement trends negatively affecting cash collections • Educate internal and external clients/customers about exceptional payer requirements • Proactively pursue payors for contracts based on volumes, payments, collection percentages, and sales opportunities • Act as liaison between the Billing A/R team and payor relations when contractual A/R issues escalate • Perform other duties as assigned

🎯 Requisitos

• 3 years of prior contracting experience • Minimum 4 years of experience in health care billing/accounting • High School Diploma required • Deep understanding of payer dynamics, value-based care models, and healthcare regulation • Proven track record in contract negotiation and end-to-end sales processes • Excellent verbal and written communication skills • Ability to meet established deadlines and handle multiple internal and external customer service demands • Strong attention to detail • Goal oriented • Ability to multitask in a fast-moving environment and manage multiple deadlines • Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint • Experience with contract management software preferred • Comprehensive knowledge of managed care for non-government payor relations programs • Intermediate Microsoft Office skills • Advanced communication skills • Advanced computer skills • Intermediate typing skills; minimum 35 words per minute • Team player • Detail oriented • Internet access required to perform job duties

🏖️ Benefícios

• Remote work arrangement • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions • Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities