logo

View all jobs

MANAGED CARE SPECIALIST (REV/CYCLE ADMINISTRATION)

New Orleans, LA
MANAGED CARE SPECIALIST (REV/CYCLE ADMINISTRATION)
 
ORGANIZATION TYPE: Not For Profit Health System
REPORTS TO: System Director of Managed Care (reports to AVP HIM)
 
POSITION SUMMARY:
  • Payor manager handles managed care contract operations
  • Participates in development of system contracting strategy for hospitals and physicians
  • Support evaluation of New Payor agreements and
  • Establishes negotiation goals for contract renewals
 EDUCATION:
  • BS/BA Healthcare Management, Accounting, Business /related minimum
  • MS/MA Healthcare Management, Accounting, Business preferred
 EXPERIENCE:
  • 5 years Managed Care, Payor, or Provider Contracting minimum
  • Excel skills with ability to navigate through contract modeling software
  • Must have working knowledge of current policies and guidelines that affect contracts, pricing in the managed care environment
  • Current working knowledge of Medicare reimbursement methodologies, fee schedule development, utilizing financial models and analysis in negotiating rates with payors
  • Knowledge of claims processing systems and guidelines
 
 
Powered by