Location: New York, NY
Duration: 9 Months
- Provides support for special projects, which includes collecting, analyzing and modeling of
- Prepares and analyzes physician practice reimbursement utilizing appropriate rates based on contract structure, place of service, provider and modifiers for each CPT code.
- Calculates Medicare reimbursement and compares to payer reimbursement for same volume.
- Responsible for all aspects of Payer Negotiations including contract language review to negotiate language with payer to ensure favorable terms.
- Works with Legal Counsel as needed to modify payer’s standard language.
- Analyzes the fee structure of the particular division and provides revenue reassessment.
- Monitors accuracy of fee structure and reimbursement payment schedules from third party payors, all cash payment deposits and refunds.
- Negotiates contracts for outstanding accounts with collection agencies.
- Performs fee schedule analysis.
- Analyzes current managed care contracts for the clinical department and assesses the financial impact on the practice.
- Proposes modifications and other pertinent strategies, including plan participation, as necessary.
- Analyzes billing administration of third party payment contracts to ensure correct billing, adjudication and payment processing and result reporting.
- Serves as a liaison to billing operations to resolve payment and other receivable issues.