Job description
About Rotech
Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com
Overview and Responsibilities
Summary
We are seeking a dedicated Contract Specialist to join our team. In this position your primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that Rotech provides service to.
Essential Duties and Responsibilities
Qualifications
Employment is contingent on
Rotech Information
Benefits
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.
Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com
Overview and Responsibilities
Summary
We are seeking a dedicated Contract Specialist to join our team. In this position your primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that Rotech provides service to.
Essential Duties and Responsibilities
- Analysis includes but is not limited to a quality review of contract plan type and class for accurate revenue tracking, payer rules to include prior authorizations, cap rental rules and appropriate document requirements which all contribute to held item and adjustments
- Maintains and creates (as needed) the code tables CAD is responsible for within Rotech's billing system
- Communicates with the Collection Centers, Central Intake, Sleep Central and locations regarding contract changes and/or updates including distribution of reference guides as required
- Conducts and leads monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team
- Conducts conference calls with payors
- Conducts contact implementations with appropriate departments as well as payer in-services
- Conducts/leads implementation calls regarding payer rule changes and/or updates with collection centers maintenance and administration of all contracts Rotech provides service for including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts Administration of contracts includes but not limited to a complete review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
- Creates FOIA requests as appropriate
- Review and publish Quick Reference Guides (QRG's) Hospice, Non-par and specified managed care contracts including the development and maintenance of Government reference guides
- Files yearly government reports such as Subcontracting report, CCR registration, Vets-100 Research of competitor information
- Maintains database of contracts within shared drive, e-Intake and Contract Logix
- Maintains pricing and other updates within the on-line ordering system
- Research and analysis of department assigned adjustments and development of monthly trend and root cause reports
- Responsible for the quality review (QA) of all contract loads and updates
- Review and analysis of Contract Quick Reference Guides submitted by the Managed Care Organization and interpreting payer rules and guidelines for appropriate set up in Contract and Item Master
- Performs other duties as assigned
- None
Qualifications
Employment is contingent on
- Background investigation (company-wide)
- Drug screen (when applicable for the position)
- Valid driver's license in state of residence with a clean driving record (when applicable for the position)
- Four year degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts
- Knowledge of Healthcare Contract Language and the ability to read and interpret Contract requirements and guidelines
- Minimum of five years directly-related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes
- Paralegal training, education or experience desired
- Effectively communicate in English; both oral and written, with employees and vendors to ensure questions and concerns are processed in a timely manner
- Helpful, knowledgeable and polite while maintaining a positive attitude
- Interpret a variety of instructions in a variety of communication mediums
- Maintain confidentiality and practice discretion and caution when handling sensitive information
- Medical terminology
- Multi-task along with attention to detail
- Self-motivation, organized, time-management and deductive problem solving skills
- Work independently and as part of a team
- Requires sitting, walking, standing, talking or listening
- Requires close vision to small print on computer and or paperwork
- Email transmission and communication
- Internet navigation and research
- Microsoft applications including but not limited to Word, Excel, Power-Point, etc.
- Office equipment; fax machine, copier, printer, phone and computer
- Office environment
Rotech Information
Benefits
- 401k
- Medical, Dental and Vision
- Life Insurance and Disability
- Generous Paid Time Off and Paid Holidays
- Bonus and Incentive Opportunities
- Mileage reimbursement (when applicable for the position)
- Telephone reimbursement (when applicable for the position)
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.
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