AMSURG, the Envision Healthcare solution for ambulatory surgery centers (ASCs), collaborates with physicians and health systems across the country to provide and promote quality patient care. We are the nationally recognized leader in the strategic and operations management of ASCs that deliver high quality, high value, same-day surgical services with a superior patient experience. Launched in 1992 as an ASC industry pioneer, AMSURG is currently partnered with nearly 2,000 specialty physicians providing outpatient surgical services in more than 250 facilities in 34 states.
POSITION SUMMARY:
The Contract Analyst will collect and analyze managed Care contract information into the AMSURG Contract Database, will interpret Managed Care contract language, research payer and government fee schedules, and other various data quality and research initiatives. The candidate will coordinate communication between the AMSURG Managed Care team, the Business Operations (RCM) team and the Facility Operations team, along with analytical support to these and various other departments. This position directly impacts AMSURG’s financial statements as the contract terms and calculations are relied upon to estimate net accounts receivable.
ESSENTIAL RESPONSIBILITIES:
- Regular coordination and communication with the AMSURG Managed Care Contracting team, Business Operations (RCM), Operations and Finance Departments to ensure timely execution and implementation of managed care strategy, data and general information.
- Interpret and analyze managed care contracts and update database(s) by entering new and updated information and ensuring data quality, validity, and utility.
- Refresh, review/quality check and maintain existing analytic reports to ensure data is current and accurate.
- Assist in the design, development and implementation of analytic adhoc reports.
- Organize and Maintain Managed Care Contract documents.
- Research, analyze, organize and maintain various Payer Fee schedules and Grouper crosswalks.
- Perform reimbursement analysis using various analytic tool, which may include SQL queries and Tableau reports for special departmental projects as needed.
- Engage and support Business Operations department through reimbursement analysis and documentation to ensure contract compliance when post-implementation audits of payor’s Explanation of Benefits (EOBs) does not match expected pay rate.
- Display initiative to test and validate complicated reimbursement terms and troubleshoot pricing discrepancies with stakeholders and colleagues when needed.
- Meet or exceed all targets and deadlines.
- Regular and reliable attendance.
- Other duties as assigned.
KNOWLEDGE AND SKILLS:
To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.
- Excellent communication skills both on the telephone and in person. Ability to read general business information. Ability to compose general correspondence. Ability to effectively present information and respond to questions from all levels of contact.
- Ability to problem solve moderate to highly complex problems without supervision and to make recommendations to management regarding highly complex problems.
- Organized, detail oriented with excellent follow through abilities. Can handle and prioritize multiple tasks. Reliable, team-oriented, pleasant with excellent interpersonal skills.
- Relies on extensive experience and judgment to plan and accomplish goals.
- Rules/regulations of Medicare/Medicaid and other government payors as well as commercial insurers and specialty contracts to ensure accurate and timely billing and payment of claims.
- Medical and insurance industry terminology.
- Must be able to exercise good judgment and positively influence and lead others, including handling confrontations with poise and efficiency.
- Based on business need, the ability to work a flexible schedule, including some evenings and weekends as approved in advance.
Education/Experience:
- Bachelor’s degree (or equivalent), preferred in business-related field or healthcare. Equivalent relevant experience will be accepted in lieu of a degree.
- Must have two to three years (2+), combination of financial analysis and payor/contract negotiations in the healthcare field.
Must pass a background check and drug screen.
We do not discriminate in practices or employment opportunities on the basis of an individual’s race, color, national or ethnic origin, religion, age, sex, gender, sexual orientation, marital status, veteran status, disability, or any other prohibited category set forth in federal or state regulations.
We are an equal opportunity employer.
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