Job DescriptionBenefits- Comprehensive Health Coverage - Medical, dental, and vision plans to keep you and your family healthy.
- Future Security: 401(k) with matching
- Student Loan Support - Up to $10,000 repayment assistance, because we invest in your future.
- Educational Tuition Assistance
- Competitive Pay & Full Benefits - A salary and package designed to reward your expertise and dedication.
Job SummaryThe Manager, Accounts Receivable Contracts oversees a team responsible for coding, testing, and maintaining managed care contracts within the contract management system. This role ensures contract terms align accurately with legal documents and assists with reimbursement system capabilities, working closely with the Reimbursement Administrator. The Manager serves as a liaison with Managed Care and financial managers to support contract modeling and enhance understanding of contract reimbursement calculations.
Essential Functions- Supervises, trains, and supports the performance of team members to meet departmental and corporate objectives.
- Manages contract implementation in the contract management system, including coding updates for new service definitions, reimbursement methodologies, and scheduled rate changes.
- Ensures accurate interpretation and programming of managed care contract language to reflect rate structures and terms as negotiated.
- Works with internal stakeholders to troubleshoot issues and verify contract calculations, providing guidance on expressions and logic for accurate contract modeling.
- Monitors updates in coding schemes (e.g., ICD, CPT, DRG) to anticipate impacts on contract terms and reimbursement structures.
- Analyzes benchmarks and performance metrics, taking appropriate action to maintain operational effectiveness and compliance with standards.
- Provides insights and recommendations to contract negotiators to ensure clarity and accuracy in contract language and terms.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
Qualifications- Bachelor's Degree in Finance, Business Administration, Healthcare Administration, or a related field required
- 4-6 years of experience in managed care contract administration, accounts receivable, or related field required
- 1-3 years of prior leadership experience preferred
Knowledge, Skills and Abilities- Strong understanding of managed care contracting, medical coding, and reimbursement methodologies.
- Proficiency with relational databases, including SQL or similar query tools.
- Knowledge of coding systems and their impact on reimbursement (ICD-10, CPT, HCPCS, DRG, etc.).
- Strong leadership skills, with the ability to motivate and develop team members.
- Effective analytical and problem-solving skills for contract interpretation and implementation.
- Excellent communication skills, with the ability to convey complex information clearly to diverse audiences.
- Proficiency in contract management software and Google Suite.
The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.
