MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:
- physician services spanning the continuum of patient care
- revenue cycle management solutions
- performance improvement consulting
We invite you to grow with us and help shape the future of health care.
- Responsible for coordinating all analytical, financial and systems support to the Managed Care Department and other departments as necessary.
- Lead the analysis and provide primary recommendations for all changes in billed charges; manage the annual review and the individual changes done weekly/daily.
- Extract and present reports from databases to be used in evaluating the performance of contracted par payors and commercial non-par payors.
- Work with department and related areas to develop evaluation tools to meet operational needs for assessing performance of payors regarding compensation, payment errors, denials and favorable/unfavorable language.
- Provide expert advanced financial analysis for the department.
- Develop standardized analytical and reporting tools, leveraging various systems, to efficiently track and model various rate analyses
- Integrate external market data (payor, gov’t, payor profitability, market share) and internal data to provide a comprehensive view of the environment for negotiators to leverage in their contracting with various payors.
- Monitor the Federal Register for changes in Medicare RVUs and CMS coding guidelines. Serve as the company’s key resource for tracking changes and assess their impacts.
- Obtain information on various payment methods and create reimbursement schedules based on contract specifications (i.e. Medicare RBRVS, St. Anthony’s conversion factors, Medicaid, percentage discounts).
- Track capitation contracts including, their payments and performance.
- Serve as a trainer and quality control expert for the Manager, Specialist and Coordinator staff in the regional offices.
- Manage the national payor contracts including service questions from provider enrollment and patient accounts, annual renegotiations, language changes, and requests for compensation changes. Negotiation of favorable rates and language.
- Liaison to information systems department on all hardware and software issues.
- Liaison to information management department on all database issues.
- Maintain documentation of tactical and actual contract terminations.
- Maintain documentation of new contract performance expectations.
- Any other duties as assigned.
- Bachelor’s Degree in a related field is required or five years related experience
- 5 years medical billing, patient accounting or managed care background; experience in health care financial management; ability to use information systems to produce management reports.
- Supervisory experiencepreferred.
- Proficiency in Word; advanced level skills in Excel, VBA, SQL database programs, and financialreport writing; excellent verbal and written communication skills; good organizational skills.