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Contracts and Revenue Coordinator in Philadelphia, PA at Resources For Human Development, Inc.

Date Posted: 2/11/2019

Job Snapshot

Job Description

Position Summary

The Contracts and Revenue Coordinator is responsible for ensuring system revenue integrity through the management of fee schedules in the electronic health records and the oversight and maintenance of the revenue contracts. This position will be responsible for reviewing and executing approved payor contracts, maintaining the contracts database, and providing contract update information to the Network, as appropriate. The contracts coordinator will have a broad understanding of payor contracting, fee schedules, coding, payor reimbursement policies, and healthcare compliance regulations.

Essential Duties and Functions

ADMINISTRATIVE

    • Enters new payor information in electronic health records.
    • Maintains payor and provider fee schedules in electronic health records.
    • Documents fee changes to ensure accountability and compliance with licensing entities and Network policies.
    • Analyzes financial impacts of changes to fee schedules.
    • Provides internal activities and training opportunities to maintain accurate fee schedule information in the Network.
    • Coordinates interdisciplinary and external meetings to review and update coding pricing and services.
    • Works with Compliance Manager to resolve all charge master related compliance procedures.
    • Coordinates knowledge with Auditing and Coding Compliance Specialist to analyze necessary CPT changes.
    • Maintains revenue contracts database.
    • Assists in strategic pricing processes to optimize reimbursement within budget and regulatory guidelines.
    • Aids revenue cycle in interpretation of contract terms and associated system pricing.
    • Communicates revenue contract requirements to discipline Directors.
    • Ensures Network compliance with respect to revenue contracts.
    • Ensures correct reimbursement is received for services as identified in the contracts, messages discrepancies to related parties.
    • Conducts payor mix and payor trending in coordination with cash poster/denial analyst.
    • Develops and maintains Revenue dashboards for each service line/site.
    • Participates in the Pay-For-Performance team.
    • Executes primary source and re-verification of credentials in accordance with HRSA and industry standards.
    • Assists in privileging staff.
    • Other revenue-related duties as assigned to support the Network.

COMMUNICATION AND INTERPERSONAL RELATIONS

    • Maintains communication with provider representatives and outside agencies regarding contracting and fee schedules.
    • Collaborate with Billing and Collections Manager regarding reimbursement issues as they pertain to coding and fees.
    • Regular communication/updates with Director of Financial Operations as related to revenue, reimbursement, and audit findings.
    • Ability to work professionally and collaboratively with department heads and clinical staff.
    • Support the Center's commitment to the creation of a trauma-informed system of care that continually recognizes and responds to the impact of traumatic stress on all those who have contact with the organization, including children, adults, families, caregivers, and staff. Uphold the commitments that include: non-violence, emotional intelligence, social learning, open communication, social responsibility, democracy, and growth and change. Specifically
        • Demonstrate cultural competence/proficiency in interactions with others by treating co-workers, colleagues and those receiving service with respect and fairness at all times.
        • Awareness and sensitivity of structural conditions and power dynamics involved in systems of oppression embedded in health care that impacts health.
        • Ability to build and maintain positive and professional relationships based on respect, trust, and safety.
        • Ability to create a space for staff and those we serve to feel physically and emotionally safe.
        • Ability to support individuals on their paths to recovery and healing and resist re-traumatization of staff and patients.
        • Demonstrate exemplary problem-solving, communication, interpersonal, and conflict resolution skills.
      • Ability to work effectively as a team member.

Qualifications


  • Bachelor's Degree in Accounting, Finance, Business Administration or health- related field (HIM) required

      • Previous experience with EMR and Practice Management Software required
      • Previous experience with healthcare payor contracting required.
      • Minimum 5 years healthcare finance experience, preferably in a large healthcare system.
      • Knowledge of Government Reimbursement (Medicare and Medicaid)
      • Able to meet strict deadlines and prioritize work effectively
    • Ability to be detailed oriented and perform tasks at a high level of accuracy