Physician Contract Application Analyst at AdventHealth

Date Posted: 11/22/2019

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Job Category
  • Date Posted:
    11/22/2019
  • Job ID:
    19023426
  • Job Family
    Managed Care
  • Travel
    No
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Corporate

Job Description


Description

Location Address: 1051 Winderley Place Maitland, FL 32751

Top Reasons To Work At AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential
Work Hours/Shift:
  • Full-Time, Monday – Friday

You Will Be Responsible For:

Systems-20%

•     Demonstrates ability to load, maintain and test contract management systems with a high level of accuracy of payment calculation. 

•     Responsible for timely entry of contract data into the Managed Care database which includes addition of new payors, renewals and terminations to ensure the accuracy of reporting provided to all Providers.

Communication-15%

•     Effectively communicates with staff, leadership, payors, and/or Providers

•     Clearly and successfully represents self and this organization in a professional, courteous manner.

•     Participates in meetings as assigned or requested.

•     Deals with patient information in a sensitive manner to ensure respect and privacy for patient and expeditious handling of related issues.

•     During negotiations of the contract, works with managed care team and other internal departments to identify issues on specific parameters or limitations of contracts, such as reimbursement, etc.

•     Provides follow up as appropriate with internal departments, providers and leadership regarding parameters of contract fee schedules.

Support and Liaison-15%

•     Supports the overall mission of Florida Hospital and the role of the Managed Care department in that mission.

•     Demonstrates an eagerness to assist co-workers in the completion of tasks as needed. 

•     Performs special projects and tasks as requested by senior staff and leadership.

•     Supports the contracting team, internal departments and providers as applicable to assist with, identify, and resolve operational, accounts receivable, billing, and other related issues.

•     Serves as liaison between Managed Care and Providers by providing continual education, support and training for the application of contracts as needed.

•     Demonstrates and encourages a team environment between hospital departments, regions and payors.

•           Information-10%

•     Keeps all pertinent payor information up to date for distribution to AHS Regional Managed Care Departments.

•     Maintains contract information in an organized manner to promote consistency in departmental operations.

•     Responsible for extracting pertinent contract information to update database which provides reports for distribution to Senior Staff, AHS MultiState Managed Care Directors and Ancillaries.

Development, Education and Training-10%

•     Displays a willingness to grow and develop skills required to perform his/her job duties and assist in the training and education of team members.

•     Takes the initiative to seek out education and training experience when there is a need and to stay informed of changes in the field of managed care and the objectives of the department.

Deadlines, Timeliness and Performance Standards-10%

•     Maintains an acceptable work pace and completes assigned tasks in the appropriate time period.

•     Does not interfere with the ability of co-workers to complete their duties.

•     In group situations, effectively contributes to the overall completion of work product according to the applicable directive and deadline.

•     Readily able to adapt to new situations and changing priorities in order to accomplish department goals.

•     Adheres to applicable internal policies, procedures and guidelines set forth by Adventist Health Systems, its associated hospitals and ancillaries during the execution of assigned duties.

•     Abides by all applicable rules, regulations, and laws prescribed by any authoritative governing body such as State regulations, AHCA, CMS, etc.


Qualifications
What You Will Need:
  • High school Diploma or equivalent
  • Minimum two years’ experience in managed care, patient financial services or provider relations
Job Summary:

This position is responsible for contract review, loading and maintenance into contract management systems for Florida and/or multi-state facilities and/or providers.  This provides the negotiated rate by payor and provider to the appropriate billing teams for reconciliation.  Consults with and assists the Contract Negotiator regarding contractual terms that could be difficult to adjudicate systematically.  Provides guidance to Regional Directors and Managed Care staff in reference to contract terms.  May enter and maintain master database for multi-state hospitals to provide Senior staff and Regional Directors with accurate reporting.  May analyze data from systems to ensure contract compliance.  Maintains strong working relationships with Regional Managed Care Departments, Managed Care Patient Financial Services (PFS), Finance/Accounting Data Processing and /or other internal departments, in order to promote compliance of contract terms. 



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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