Company :Allegheny Health Network
Job Description :
Responsible for maintenance of facility contracts in EPIC contract management system ensuring accurate adjudication of AR for Revenue Cycle as well as accurate payments from payors. Responsible for hospital contract analysis including contract modeling and monitoring of contract performance. Additionally, this role will provide accurate and timely hospital reimbursement and payor policy information to various departments across Allegheny Health Network.
Essential Job Functions:
Manage contract loading and refreshing of contract terms in contract management system. Ensure accuracy of contracts in the system. Oversight and responsibility for knowing effective dates of contract changes, updates and implementation dates.
Manage underpayment work queues and manage team responsible for working the queues.
Perform analysis of underpayment or denial trends to determine root cause and opportunities for work flow or contract changes.
Provide supervision and guidance to direct reports. Review performance standards and establish goals and objectives for the departments. Coaching and mentoring managed care and follow up teams.
Manage underpayment vendor logs and access to AHN systems.
Bachelor's degree in Finance, Business, or Healthcare Administration
5-7 years experience in health care: provider or insurance
1-3 years management experience
Expertise with various government hospital reimbursement methodologies.
Previous experience with hospital reimbursement analytics
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