Contract Specialist I

Join the Leader in the Home Healthcare Industry! Let us be your Road to Success Rotech is seeking a Contract Specialist I to join our team. In this position your primarily responsibility is the maintenance and administration of both Contracted and Non-Contracted Payers that Rotech provides service.
Why work for Rotech? If we take a look at all the ways employees benefit from working at Rotech, we have a philosophy we like to call: "The Rotech Difference."
What's the Rotech Difference? It's made up of all the benefits, services and offerings available to Rotech Employees. It is the employee-based strategies that make our company an employer of choice in the healthcare industry. As a member of the Rotech Healthcare Team, employees can take advantage of many great opportunities as part of their career path.
Responsible for the Quality Review (QA) of all Contracts loads and updates
Conducts and leads monthly team meetings to review top account issues, denials, adjustments and held item errors and recommends quarterly review topics to the managed care team
Communicates with the Billing Center, Central Intake, Sleep Central and Locations regarding contract changes and/or updates including distribution of reference guides as required
Conducts/leads implementation calls regarding payer rule changes and/or updates with billing centers
Maintenance and administration of all Contracts Rotech provides service for including but not limited to Managed Care, Government, Hospice, Skilled Nursing, Non-Participating or Out of Network, Professional Service Agreements and Patient Pay Contracts
Administration of contracts includes but not limited to a complete redline/review of payer contract language, policies and procedures, provider manuals, billing rules and guidelines
Participates and assists with the research and preparation of Request for Proposals (RFP) and solicitations as required
Development of Quick Reference Guides (QRG's) Hospice, Non-par and specified Managed Care
Contracts including the development and maintenance of Government reference guides as required.
Research and analysis of department assigned adjustments and development of monthly trend and root cause reports
Conducts Contact implementations with appropriate departments as well as payer in-services as required
Review and analysis of Contract Quick Reference Guides submitted by the Managed Care Organization and interpreting payer rules and guidelines for appropriate set up in Contract and Item Master.
Analysis includes but is not limited to a quality review Contract Plan type and Class for accurate revenue tracking, payer rules to include prior authorizations, cap rental rules and appropriate document requirements which all contribute to held item and adjustments
Monitors the release of solicitations daily and maintains a list of active solicitations within company database.
Maintains database of contracts within shared drive, e-Intake and Contract Logix
Creates FOIA requests as appropriate
Files yearly government reports such as Subcontracting report, CCR registration, Vets-100
Research of competitor information
Conducts conference calls with payors as required
Maintains pricing and other updates within the online ordering system as required
Contacts potential customers to seek new business as directed
Assists in creating and maintaining Rotech's Supplier Diversity Database including yearly mailing to all Rotech vendors.
Required to have a minimum of five years directly-related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes.
Knowledge of Healthcare Contract Language and the ability to read and interpret Contract requirements and guidelines
Four year degree or equivalent combination of college education and/or related work experience in healthcare, billing, and/or industry contracts.
Paralegal training, education or experience desired
Physical Demands:
Walk, sit, talk, and listen for extended periods of time
Regularly review documents with small print
Utilize computer for long periods of time
Rotech Offers:
Competitive Compensation
Career Path and Management opportunities
Health and wellness benefits to include medical, prescription, dental and vision plans, short term and long term disability, supplemental life insurance and flexible spending accounts
Employee Assistance program
PTO and paid holidays
Employee Discounts
Employee Referral program
Employee Recognition program
Make the right move, Contact us today!
This process will take approximately 2-5 minutes to complete. The hiring manager will review your resume and contact you if your qualifications match our needs. We appreciate your interest in Rotech Healthcare Inc.
Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities
Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.

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