Responsibilities
- Interpret reimbursement methodologies to evaluate, document, and manage hospital contracts with various payers using dedicated contract management software.
- Examine detailed contract terms and payment rates provided by clients to extract essential elements for correct system setup.
- Monitor official payer websites and regulatory publications to track changes in payment rules and coverage policies.
- Verify system-calculated payment estimates against client claims data, identifying and resolving inconsistencies from input errors or policy misapplication.
- Maintain fidelity of contract implementation by aligning system configurations with client specifications and payer agreements.
- Address client inquiries related to payment valuations within established response time standards.
- Engage in internal and external meetings to support project alignment and resolve contractual or technical issues.
- Support initiatives to improve workflows by reducing manual processes and increasing data reliability.
Work Arrangement
Remote (Worldwide)
Team
Reports to: Senior Director, Client Training & Contract Definition
