Contracts Administrator - Homed Based - #1409367

Overview

Are you looking for a purposeful career that will make a difference in the patient community? At CCS, our approach to at-home patient care is redefining chronic care management. We are seeking individuals that will thrive in a patient-centric dynamic environment. If you are an attentive listener, fast-thinker, and problem-solver, with the ability to relate to different people, you are a match for CCS.

As a Contracts Administrator you will be responsible for Managed Care Organization (MCO) documentation analysis from a contractual perspective. Charged with analyzing and presenting contract implementation solutions for CCS Medical for consideration.

Responsibilities

• Compiles MCO documentation and records information for tracking purposes
• Analyzes related MCO documentation from a contractual perspective
• Analyzes payer changes alerting management to changes in coverage criteria that would impact CCS
• Analyzes and recommends changes to reimbursement and operational processes for increased productivity
• Uncovers all aspects of contract functionality and the impact operationally
• Provides detailed outlines of the overall work flow and implementation of contractual requirements
• Compiles and proposes actions based on analysis
• Involved in the analysis of operational opportunities within CCS Medical
• Completes applications to grow current and future business
• Maintenance of existing contracts to retain existing business
• Analysis signed contracts to extract data and evaluate existing business
• Inputs data for PBM transactions and assists in resolution of network issues
• Communication with MCO to resolve problems or issues and to seek guidance or clarification of contractual provisions as well as operational and reimbursement requirements
• Assists with updates to fee schedules for contracted payers
• Maintains a high degree of confidentiality at all times due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements
• Abides by all regulations, policies, procedures and standards
  
  

Qualifications

• High school diploma or GED equivalent with two or more years of related experience, or equivalent combination of education and experience
• One to two years Revenue Cycle experience preferred
• Demonstrated ability to read and interpret documents such as policies and procedure manuals, third party contracts, and Medicare and state Medicaid regulations
• Excellent written communication skills required
• In-depth knowledge of multiple department operations preferred
• Attention to detail and time management
• Ability to work productively under pressure and to prioritize and manage multiple assignments simultaneously
  
  

Values

Values

Certainty-The lives of the individuals we serve depend on our ability to execute. We commit to doing this every day.

• Use appropriate methods and a flexible interpersonal style to help build a cohesive and collaborative team based on a foundation of trust and transparency. Deliver what you commit to.
  
  

Compassion-We understand the burdens of patients and their loved ones and channel this into a relentless pursuit of customer satisfaction in every part of our business.

• Ensure that the patient is the driving force behind business decisions, implementing service practices that meet needs of both the patient and the organization. Treat other the way you want to be treated.
  
  

Advancement-We are endlessly looking for ways to progress and become more innovative in all things we do.

• Encourage innovative approaches for addressing opportunities and facilitating change, driving cross-functional alignment to accomplish goals. Speak the truth.
  
  

CCS Medical and EEOC/AA employer. M/F/D/V