CCS Medical

  • Contract Administrator (Medical)

    Job Location US-FL-Clearwater
    ID
    2018-2239
    Category
    Administrative/Clerical
    Position Status
    Regular Full-Time
    Position Schedule
    Monday-Friday
    Shift
    8-5
  • Overview

    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
    • 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
    • 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


    Equal Opportunity Employer/Veterans/Disabled

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