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Contract Modeler(Insurance contracts exp. a plus; Microsoft Excel exp. a must)- San Antonio

Contract Modeler(Insurance contracts exp. a plus; Microsoft Excel exp. a must)- San Antonio

Job Description

Parallon pioneered the modern-day concept of healthcare shared services more than 12 years ago, perfecting revenue cycle management best practices and customizable technologies for the industry’s largest healthcare provider in 700 facilities and 1000 physician practices. Today, our team of more than 13,000 revenue cycle professionals applies unmatched expertise, scale and proven processes daily to improve financial performance and long-term sustainability at facilities nationwide.

 

GENERAL SUMMARY OF DUTIES – Translates managed care contract terms and model relevant parameters in Contract Profiler and Calculator Model (CPCM) to ensure accurate discounts on patient accounts and proper reflection of expected net revenue.

DUTIES INCLUDE BUT ARE NOT LIMITED TO:

• Coordinate managed care contract implementation activities with the Contract Negotiators, Payor

Representatives and the Functional Managers within PAS

•Liaison with PAS Functional Managers and Managed Care Negotiators and Payors to address managed care contract administration issues

•Maintain and control managed care I-Plans in accordance with corporate standards and PAS procedures

•Model managed care contract payment terms using CPCM (or other approved modeling tools)

•Coordinate with IT&S Reimbursement Product Support for modeling of government or other contracts modeled directly in the Payment Calculator System

•Publish and maintain Automated Quicksheets in the Contrack system for managed care contracts

•Provide educational resources to support contract implementation and administration

•Attend  PAS management meetings or facility contract management teams as necessary

•Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

•Other duties as assigned

Job Requirements

EDUCATION

•    Bachelor’s degree in Business, or Bachelor’s in another field with appropriate healthcare business experience

•    3-8 years medical finance, managed care contracting, or business office/claims shop operations experience

EXPERIENCE

•    Excellent oral and written communication skills

•    Self motivated.  Able to work independently and as a team member

•    Analytical

•    Detail oriented

•    Excellent PC skills

•    Excellent People skills

•    Management skills

•    Organizational skills

CERTIFICATE/LICENSE - N/A

Parallon is an Equal Opportunity Employer (EOE), Minority/Female/Veteran/Disabled, offering a great work environment, challenging career opportunities, and competitive compensation.

Lack of information can delay the application process, and therefore applicants should be thorough in completing the online application.

Job Snapshot

Employment Type Full-Time
Job Type Information Technology
Education 4 Year Degree
Experience At least 12 year(s)
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified
Job ID 08949-88182
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Contract Modeler(Insurance contracts exp. a plus; Microsoft Excel exp. a must)- San Antonio


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