Under general supervision, participates in the negotiation of Managed Care agreements. Responsible for monitoring and coordinating Managed Care contractual arrangements for all affiliated entities of the medical facility. Analyzes contractual language for functional, financial and ethical appropriateness, determining compliance and consistency with established legal requirements and parameters.
Responsible for maintaining and resolving payment and contractual issues with assigned payers. Coordinate meetings with assigned payers to discuss updates and claim issues when necessary. Participates in reviewing, understanding, and interpreting new and existing Managed Care relationships/contracts, including value based, shared savings and incentive programs for negotiation, renegotiation, and termination (when appropriate). Establish, track, and maintain letters of agreement (LOA), and single case agreements (SCA) with commercial, Medicaid, and Medicare health plans. Delivers new and updated fee schedule data that accurately reflects contract language, rates, and intent. Assists with Payer setup process, education on new and existing payer relationships and coordinates administrative access duties for: Rev. Cycle, department staff to appropriate web portals, and web dashboard related payer tools. Responsible for disseminating payer updates and changes to the organization. Communicates Managed Care updates and content within the department and organization through internal systems, including but not limited to: SharePoint, website information, and newsletters. Builds a collaborative relationship with internal/external staff. Collaborates with Patient Accounts staff in working on Payer contracts/Claims/Administrative issues. Performs all other duties as assigned. Fundamental knowledge of claims processes, medical management processes, medical terminology, and CPT coding. Fundamental knowledge of reimbursement methodologies, including Fee-for-service (FFS) and Professional Reimbursement. Academic knowledge a plus. Fundamental knowledge of industry regulations related to contracting and negotiation techniques Ability to build and maintain positive working relationships, with individual work groups, across departments and external contacts, through open communication and collaboration. Detailed in documenting information, highly organized, and practices good follow-through techniques. Proficiency in word processing, spreadsheet, and database software. Expereince:Four (4) years experience is required. Education: Bachelors Degree in Business Administration or a healthcare field is required.
UAPayer Relations and Contract Coordinator-Intermediate
UT Health San Antonio is committed to enhancing health through education, research, and patient care.
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Full Time
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Mid-level
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United States +/- 0 hoursAbout UT Health San Antonio
Learn more about UT Health San Antonio and their company culture.
UT Health San Antonio is a leading academic health center with a mission to make lives better through excellence in advanced academics, life-saving research and comprehensive clinical care. Across its missions of research, education, patient care and community service, The University of Texas Health Science Center at San Antonio, also called UT Health San Antonio, remains relentlessly committed to advancing the health of all in San Antonio and the surrounding region.
With an annual portfolio of biomedical research of more than $436 million, the university is a primary driver of the city’s $44.1 billion health care and biosciences sector. Through its six schools, a diverse workforce of nearly 9,500, an annual expense budget of $1.67 billion and a clinical practice that provides 2.5 million patient visits each year, UT Health San Antonio generates a substantial economic impact across South Texas as it daily serves the public good. UT Health San Antonio is a dynamic and rapidly expanding health science center with six professional schools (medicine, nursing, dentistry, health professions, graduate school of biomedical sciences, and public health) with missions of education, clinical care, research, and community service.
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