Contract Administration Specialist LOOKING FOR Contract Administration Specialist JOB AT Orlando, FL

OVERVIEW
Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com

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JOB INFORMATION
Summary
We are seeking a dedicated Contract Administration Specialist to join our team. In this position you will be primarily responsible for the complete maintenance and administration of two separate company systems; maintaining contract rules, guidelines and pricing methodologies, as well as analyzing contracted fee schedules and payment variations through denials and EOB’s with a goal of reducing company total held item, adjustments and mitigating financial risks to the company.
Essential Duties and Responsibilities

• Analyze each request to ensure proper claims submission via electronic or paper as well as correct payor requirements are applied (i.e. invoice vs. 1500 form, payor claim requirements, etc.)
• Conduct pricing maintenance and administration to contract and item master as required
• Daily maintenance and administration of Rotech Global Carrier codes (claims submission and set up), prior authorizations rules within both item master and e-intake
• Ensure appropriate contract to global carrier links to make certain the correct carrier/ contract link is set up so the appropriate payer rules and pricing are extracted
• Maintenance and administration of Medicare competitive bid contracts
• Research and analyze daily contract and/or item master requests submitted by the billing centers and locations by reviewing contract language, rules and pricing to ensure requested change is appropriate and within contract requirements; further analysis is required if variances in requests are found to be different from contract, which may require contacting the payer and/or the responsible Managed Care Director or Business Account Manager in addition to other available resources that may include payment history within Emdeon payment manager
• Research and analyze document requirement changes (Cert files-SOP vs. CMN)
• Resolves identified claims issues in a timely fashion to mitigate financial risk in Rotech’s claims processing cycle (avoid held item issues, etc.)
• Review and analysis of contract quick reference guides submitted by the managed care organization and interpreting payor rules and guidelines for appropriate set up in contract and item master; quality review of contract plan type and class for accurate revenue tracking, payer rules to include prior authorizations, cap rental rules and appropriate document requirements which all contribute to held item and adjustments
• Performs other duties as assigned

Supervisory Responsibilities

• None

QUALIFICATIONS
Employment is contingent on

• Background investigation (company-wide)
• Drug screen ( when applicable for the position )
• Valid driver’s license in state of residence with a clean driving record ( when applicable for the position )

Education and/or Experience

• Experience of healthcare contract language and the ability to read and interpret contract requirements and guidelines
• Three years directly-related experience in the medical industry working with HCPCS, CPT and ICD-9 Codes; required
• Two year degree or equivalent combination of college education and/or related work experience in healthcare, billing and/or industry contracts

Skills, Knowledge and Abilities

• Effectively communicate in English; both oral and written, with vendors, employees, etc. to ensure questions and concerns are processed in a timely manner
• Helpful, knowledgeable and polite while maintaining a positive attitude
• Interprets a variety of instructions in a variety of communication mediums
• Knowledge of Durable Medical Equipment (DME) or Home Medical Equipment (HME)
• Multi-task along with attention to detail
• Self-motivation, organized, time-management and deductive problem solving skills
• Work independently and as part of a team

Physical Demands

• Lift and carry up to 10 pounds at times
• Requires sitting, walking, standing, talking or listening
• Requires close vision to small print on computer and or paperwork

Machines, Equipment and Technical Abilities

• Email transmission and communication
• Type on a computer and or a tablet
• Internet navigation and research
• Microsoft applications including but not limited to Word, Excel, Power-Point, Publisher, Access, etc.
• Office equipment; fax machine, copier, printer, phone and computer

Work Environment

• Office environment

ROTECH INFORMATION
Benefits

• 401k
• Medical, Dental and Vision
• Life Insurance and Disability
• Generous Paid Time Off and Paid Holidays
• Bonus and Incentive Opportunities (Non-Exempt and Exempt)
• Mileage reimbursement (when applicable for the position)
• Telephone reimbursement (when applicable for the position)

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Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees. Rotech Healthcare Inc. is a DRUG FREE WORKPLACE