THIS POSITION IS LOCATED IN OUR CHATTANOOGA CORPORATE OFFICE ON LEE HWY AND THE SELECTED CANDIDATE WILL HAVE THE OPPORTUNITY TO WORK WITH MANY OF OUR AWESOME ASSOCIATES!
Responsible for the collection of all contracted Payor fee schedules (as applicable) to include our top payors and collection of all State Workers Compensation Medical Fee Schedules. Also, responsible for completing special projects as assigned. This position is responsible for supporting the mission, vision and values of the company. QUALIFICATIONS - REQUIRED:
Education: Undergraduate degree preferred. Experience: 4 years experience required in the Healthcare environment with exposure to contract fee schedules. * Knowledge of the outpatient rehabilitation industry is strongly preferred. Microsoft Office, Excel, Pivot Table, outlook Skills: Demonstrated ability in Microsoft excel required (intermediate) Ability to manage multiple priorities including understanding various insurance products and levels of benefit within each product. Knowledge of CPT, HCPCS, AND ICD-10 codes and understanding of medical terminology strongly preferred Ability to work independently and demonstrate good judgment Excellent interpersonal skills - ability to communicate accurately and effectively with internal and external stakeholders Highly organized, quick learner, with ability to multitask and prioritize work effectively Creative problem solver with demonstrated ability to provide pragmatic solutions to complex business problems Relevant work experience demonstrating an understanding of the principles of healthcare delivery and finance. Environment: Works in an office environment Hours of Work: Monday through Friday our normal business hours. May be required to work overtime as requested. Travel: Very limited if any Physical Requirements: This position requires moderate physical activity in an office environment. Other activities may include bending, standing/sitting for long periods of time and climbing ladders. Requires frequent computer use.
Collection of all contracted payor fee schedules (as applicable) to include our top payors; collection of all State Workers Compensation Medical Fee Schedules. Organization and maintenance of all fee schedule data (Excel - pivot table experience here would be awesome); Announcement of all new and renegotiated payor Agreements to include effective date, plan types included (HMO/PPO/Etc.), applicable Benchmark groups/Tax ID numbers and clinic locations (as applicable), and applicable rate information (as directed); Load, validate, and maintain all contract maintenance records for all payor Agreements; Develop, validate and schedule applicable reporting from the contract maintenance app/OneApp; Field, catalogue/track, and research incoming contract inquiries; respond as directed; maintain flow of incoming inquiries and gather timely and accurate responses; Track, research and respond to routine payment issues (A/R issues received via Revenue Cycle that pertain to specific contracting issues, repeated payment patterns, etc.), as directed; Enter fee schedules into financial modeling tool; pull sample EOBs and consolidate findings (again pivot table experience here would be great!); Pull, assimilate and consolidate top payor data using industry leading tool; distribute to internal stakeholders as directed; Follow up with payors regarding Agreements submitted for countersignature to ensure we have received a fully executed copy; Prepare Agreements for signature; Request and obtain all supporting documentation from Credentialing that will accompany all Agreements (i.e., W9, roster of providers and locations, etc.); Receive and prepare all single case Agreements for the approval of the VP, Payor Relations; Other duties as assigned.
JOB SUMMARY: As a key member of the Upstream IT team, the QA Analyst is responsible for delivering high quality testing results through solid technical and analytical skills in support of strategic cross functional projects. Incumbent will develop and execute test plans, test scripts and document defects.
UPSTREAM REHABILITATION IS AN EQUAL OPPORTUNITY EMPLOYER.
Required Skills Required Experience