Brentwood, Tennessee
Payer Contract Administrator Job Opening in Brentwood, Tennessee - Purpose
The Payer Contract Administrator will be expected to oversee the contract management process in its entirety. This role will be solely responsible developing and maintaining a process for document management. This position requires extensive experience with payer contract negotiation. Further, this position will require close collaboration with various department, including but not limited to, Revenue Cycle, Operations, and Legal. The Payer Contract Administrator will be the primary CPS contact for the provider network community.
Maintain deadlines and deliverables while communicating on a continuous basis with Revenue Cycle Teams regarding contract matters.
Develop and execute negotiation strategies that minimize potential losses and benefit the CPS organization?s financial performance.
Draft payer contracts, provisions, and amendments based on organizational needs and expectations.
Assure accuracy and appropriateness of contract language and attachments, including fee schedules.
Apply CPS organization and industry standards when developing requests for proposals, negotiating terms, and drafting/editing contracts.
Analyze and interpret contractual, legal, regulatory, and legislative provisions to ensure group and individual payer contracts meet business and regulatory compliance.
Review requests for new contracts and/or amendments and solicit appropriate approvals from internal leadership.
Create and maintain current payor contract document management process in Salesforce Software System while ensuring the information has been properly entered and is securely maintained.
Provide status of payer contracts on a quarterly basis and update Revenue Cycle Management Teams of changes to ensure providers are linked to appropriate contracts.
Collaborate with Revenue Cycle Teams to assist with resolving contractual claims issues related to contract language, potential breach, fee schedules, and any other aspect of said contract.
Works closely with the Director of Revenue and operations staff to complete work que and front end operations activity that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement in a variety of areas, including but not limited to: coding, claim submission, insurance and self-pay collections, refunds and write off approvals.
Job Type: Full-time
Required education:
Bachelor's
Required experience:
physician owned healthcare: 3 years
payer contract regulatory compliance: 3 years
working with payer contracts: 5 years
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