Healthcare Contract and Fee Schedule Analyst Consultant

posted on October 5, 2018

Job Description

Location: New York, NY

Duration: 9 Months

Responsibilities:

  • 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.