Analyst

Payor Contract Review SpecialistThis employee reviews payor contracts and information associated to contractual obligations including payor fee schedule changes and posted policy updates for various payors. They will work with Managed Care Contract Administrators, Payor and Price Table Team, and other required departments to ensure that policy guidelines and changes are updated accordingly and timely.Job FunctionsContacts payors at times to discuss policies and/or changesDocuments payor requirements according to their policies as well as payor changes and relays changes to the appropriate departmentsPursues, maintains, and communicates medical guideline changesHelps facilitate interoffice communication on payor updates and changesWorks with the Payor and Price Table team to ensure that policy changes are updated accordinglyWorks assigned payors accordingly and timelyAvailable to assist other members on the team with questions and/or needsAnswers payor policy questions accordinglyAssists in identifying payor changes that need to be addressedWorks with BIS, payor, and price table group to ensure that payor policies are followed and updated accordingly to payor guidelines once changes have been identifiedCommunicates with the payor regarding policy informationAssists with the delivery directives from Corporate office as they apply to policy changes and/or updatesEducationHigh School Diploma or General Education Degree (GED) RequiredKnowledge, Skills, and AbilitiesKnowledge of the medical field preferredBasic computer skillsPositive and cooperative attitude in working and communicating with individuals at all levels of the organizationWrite reports, business correspondence, and procedure manualsEffectively present information and respond to questions from groups of managers, clients, customers, and the general publicTelephone etiquette alongside adequate oral and written communication skillsShows effective multitasking skills