Title: Payor Contracting and Rate Negotiations Expert
- Seeking a highly experienced individual with hands-on experience negotiating payor contracts and fee schedules for our clients.
- Results driven expert that has a proven track record of increasing payor fee schedules.
- Thorough understanding of contract language.
- Auditing codes and fee schedules – Benchmarking reimbursements against local Medicare Rates to identify weaknesses in their current reimbursements.
- Thorough understanding of CPT Codes and reimbursement language.
- Ability to speak with our clients to determine what’s important to their practice and to have a thorough understanding of the provider’s specialty(s).
- Ability to educate our clients on proper coding.
- Thorough understanding of HCFA’s, EOB’s and claim denials in order to assist educate our clients and assist with clean claims.
- Audit and determine our clients practice’s high-volume procedures; understanding of E/M codes, ICD-9’s, etc.
- Understand if the practice does consultations, preventive exams, in-house labs, X-rays, injections, supplies, and other services that are valued outside the ‘traditional’ RBRVS fee schedule, before contacting any payer.
- Ability to write clear and precise impactful proposal letters to the networks and have key contacts at the networks.
- Seeking an individual with in-depth knowledge and experience with payor contracts, fee schedules, coding, reimburements, etc.
- Medical Biller/Coder Certification a plus, but not required.
- College degree desired but not required.
- Ideal candidate must be highly self-motivated with proven expertise in the healthcare physician credentialing, expirables management, and medical licensing experience is a plus.
- Ability to perform multiple assignments, good organizational, and time management skills.
- Strong clerical and computer skills.
- Strong organizational and follow up skills.
- Proficiency in Microsoft Office. Knowledge of credentialing software is helpful, but not required.
- Ability to interact effectively with a variety of people (physicians, mid-levels, medical staff offices, ancillary staff, and insurance reps).
- Provides the highest level of customer service to our customers.
- Strong written and verbal communication skills.
- Strong presentation and client interaction skills.