Contracts Administrator

Description

Job Summary:  As the Contracts Administrator, you will oversee the health system’s revenue-generating contracts and provider enrollments. You will complete third-party contracts and provider enrollments to increase revenue, including contracting with Medicare and Medicaid. You will report to the Manager.

PG12 | Full Time - Durant Clinic | Schedule: Monday through Friday 8:00am to 4:30pm |

Weekly Earned Wage Access is an Option for this Position | 

Primary Tasks:

1.      Analyze requirements and provisions in revenue contracts to ensure compliance with regulations, Choctaw Nation Health Services policies, and tribal sovereignty protections.

2.      Monitor the performance of assigned contracts and ensure our goals are met by implementing contract management and reporting discrepancies.

3.      Prepare status reports and review contracts.

4.      Enroll and contract CNHSA providers with Medicare, Medicaid, MCO(s), and other commercial payers.

5.      Develop framework to renew and re-evaluate third-party payer contracts and provider enrollments promptly.

6.      Communicate with internal departments to ensure access to all contractual data to enroll and bill third-party payers for services performed.

7.      Assist internal billing with issues related to contracting and appeals.

8.      Communicate with external entities to acquire necessary data.

9.      Review healthcare reform and insurance carriers policies; attend meetings regarding provider enrollments, contracting, and revenue or third-party reimbursement.

10.   Perform other duties as assigned.

Required Education and Experience:

·       Bachelor’s degree in finance, business, or health related field

·       Experience with public speaking and presentations

·       Experience in analytics and reporting

·       Three [3] years’ experience in health contract preparation and management

Responsibilities
1.      Analyze requirements and provisions in revenue contracts to ensure compliance with regulations, Choctaw Nation Health Services policies, and tribal sovereignty protections. 2.      Monitor the performance of assigned contracts and ensure our goals are met by implementing contract management and reporting discrepancies. 3.      Prepare status reports and review contracts. 4.      Enroll and contract CNHSA providers with Medicare, Medicaid, MCO(s), and other commercial payers. 5.      Develop framework to renew and re-evaluate third-party payer contracts and provider enrollments promptly. 6.      Communicate with internal departments to ensure access to all contractual data to enroll and bill third-party payers for services performed. 7.      Assist internal billing with issues related to contracting and appeals. 8.      Communicate with external entities to acquire necessary data. 9.      Review healthcare reform and insurance carriers policies; attend meetings regarding provider enrollments, contracting, and revenue or third-party reimbursement. 10.   Perform other duties as assigned.

Qualifications
·       Bachelor’s degree in finance, business, or health related field ·       Experience with public speaking and presentations ·       Experience in analytics and reporting ·       Three [3] years’ experience in health contract preparation and management