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Contract Administration Specialist I in Orlando, FL at Rotech Healthcare Inc.

Date Posted: 11/26/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Orlando, FL
  • Job Type:
  • Experience:
    At least 3 year(s)
  • Date Posted:
    11/26/2018

Job Description

Overview

Join the Leader in the Home Healthcare Industry! Let us be your Road to Success Rotech is seeking a Contract Administration Specialist to join our team. In this position you will be primarily responsible for the complete maintenance and administration of two separate Rotech Systems. This position will be responsible for maintaining Contract rules and guidelines. Position responsibilities include, but are not limited to Contract/ Payor Rules, guidelines and pricing methodologies, as well as analyzing contracted fee schedules and payment variations through denials and EOB's with a goal of reducing company total held item, adjustments and mitigating financial risks to the company.

Why work for Rotech? If we take a look at all the ways employees benefit from working at Rotech, we have a philosophy we like to call: "The Rotech Difference."

What's the Rotech Difference? It's made up of all the benefits, services and offerings available to Rotech Employees. It is the employee-based strategies that make our company an employer of choice in the healthcare industry. As a member of the Rotech Healthcare Team, employees can take advantage of many great opportunities as part of their career path.

Responsibilities
  • Review and analysis of Contract Quick Reference Guides submitted by the Managed Care Organization and interpreting payor rules and guidelines for appropriate set up in Contract and Item Master. 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
  • Responsible for researching and analyzing daily Contract and/or Item master requests submitted by the billing centers and locations by reviewing Contract language, rules and pricing to ensure requested change is appropriate and within contract requirements. Further analysis is required if variances in requests are found to be different from Contract, which may require contacting the payer and/or the responsible Managed Care Director or Business Account Manager in addition to other available resources that may include payment history within Emdeon payment manager
  • Performs daily maintenance and administration of Rotech Global Carrier codes (Claims Submission and Set Up)
  • Responsible for analyzing each request to ensure proper claims submission via electronic or paper as well as correct payor requirements are applied (i.e. invoice vs. 1500 form, payor claim requirements, etc\u2026.)
  • Responsible for ensuring appropriate Contract to Global Carrier links to make certain the correct carrier/ contract link is set up so the appropriate payer rules and pricing are extracted
  • Responsible for conducting pricing maintenance and administration to Contract and Item Master as required.
  • Responsible for researching and analyzing document requirement changes (Cert files-SOP vs. CMN).Prior Authorizations rules within both item master and eintake
  • Responsible for the Maintenance and Administration of Medicare Competitive Bid Contracts
  • Resolves identified claims issues in a timely fashion to mitigate financial risk in Rotech's claims processing cycle (avoid Held Item issues, etc.)
Qualifications
  • Required to have a minimum of three years directly-related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes
  • Knowledge of Healthcare Contract Language and the ability to read and interpret Contract requirements and guidelines
  • Two year degree, or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts

Physical Demands:

  • Walk, sit, talk, and listen for extended periods of time
  • Regularly review documents with small print
  • Utilize computer for long periods of time

Rotech offers:

  • Competitive Compensation
  • Career Path and Management opportunities
  • Health and wellness benefits to include medical, prescription, dental and vision plans, short term and long term disability, supplemental life insurance and flexible spending accounts
  • Employee Assistance program
  • PTO and paid holidays
  • 401K
  • Employee Discounts
  • Employee Referral program
  • Employee Recognition program

Make the right move, Contact us today!

This application process will take approximately 2-5 minutes to complete. The hiring manager will review your resume and contact you if your qualifications match our needs. We appreciate your interest in Rotech Healthcare Inc.

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, 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.