Contract Analyst

Job Description

The Contract analyst develops and maintains contract related information in an electronic format, loads rates into MS4 Expected Reimbursement or its successor, prepares contract reimbursement overviews, tracks and on a monthly basis reports all required health plan notifications. Identifies and resolves contract-related operational issues in a timely and efficient manner. Duties will include processing all payor credentialing requests as well as managing all routine department communications.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women's health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

Required Skills

• Excellent customer services skills.
• Analytical and problem solving skills are a must.
• Demonstrated ability to effectively produce assignments within required time frames.
• Demonstrated outstanding skill in prioritizing work tasks and assignments.
• Demonstrate sound decision making and prioritization skills.
• Able to multi-task.
• Literacy in PC applications such as Word and Excel (Access preferred).
• Demonstrates ability to extract, compile and format data to produce a variety of reports and presentations.
• Previous experience with databases, including report writing and design is preferred.
• Good mathematical skills.
• Strong verbal and written communication skills required.

Required Experience

Required:

• High school graduate.
• Experience in managed care, extensive knowledge in payment methodologies, stop loss, DRGS, HCPCS and ICD-9 codes, per diems, exceptions, etc.
• Extensive experience analyzing rates, utilization data and developing pricing models.
• Intermediate to advanced user of spreadsheet and database.
• Understands UB04/837 data elements.