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Contract Implementation Analyst I - Provider Reimbursement

Company: HCSC
Location: Richardson
Posted on: May 3, 2021

Job Description:

Job ID: EMO-1041864

Description:

Located in Richardson, TX this position is responsible for reviewing non-standard contracts for system capacity, implementing and auditing contract completion, handling contract inquiries by conducting research and coordination through various departments in resolution and responding to inquiries, conducting contract analysis and modeling, conducting quality control and analysis of quality reporting, preparing quality improvement recommendations, and develop documentation and training materials.

Required Job Qualifications:

  • 4-years of experience working in a managed care/ healthcare environment.
  • 1-year experience in healthcare contract pricing implementation and audit experience.
  • Health care management database experience. Experience in one or more of the following systems; Access, Blue Chip, Vistar, Terminal Emulator, Premier Pricing, and/or Premier Provider.
  • Knowledge of managed care contracts.
  • Knowledge of CPT, HCPCS, ICD9, Revenue code, and/or DRG coding practices.
  • Project management experience.
  • Technical documentation skills.
  • Leadership skills.
  • Flexibility to meet deadlines in an environment of constantly changing priorities and workloads.
  • Analytical skills including modeling.
  • Verbal and written communications skills including interpersonal skills to work across the organization to resolve problems, responding to inquiries, compose procedure manuals and training materials, and to discuss business and technical aspects with all levels of management.
  • Knowledge of both mainframe and windows based applications.
  • PC skills including Microsoft Office with proficiency in Excel.

Preferred Job Qualifications:

  • Bachelor degree

This position must be located in Richardson, TX.

exhibit, rates, DRG, Groupers, Parm Rate, Pen Report, tera data

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Requirements:

Expertise Other, Quality Assurance, Physician, Accounting / Finance, Network Management / Provider Relations, General Health Care, Claims & Customer Service Job Type Full-Time Regular Location TX - Richardson

Keywords: HCSC, Richardson , Contract Implementation Analyst I - Provider Reimbursement, Other , Richardson, Texas

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