What are the responsibilities and job description for the INSURANCE CONTRACT ADMINISTRATOR position at Covenant Healthcare?
Covenant HealthCare
US:MI:SAGINAW
8:00 AM - 4:30 PM, MONDAY - FRIDAY
FULL TIME BENEFITED
Summary:
To develop, maintain, implement and monitor contractual relationships with third party Insurance Payors on behalf of Covenant and its business units.
Responsibilities:
PRINCIPAL DUTIES AND RESPONSIBILITIES: 1. Under supervision of Director or Managed Care Contracting, works directly with Payors to negotiate contractual provisions and rates on behalf of Covenant Hospitals, Medical Group, Behavioral Health Services and other business units. 2. Independently evaluate and analyze contract proposals including completing initial proposal responses and reviewing/revising contract language and operational requirements. Reviews contracts with in house legal-council and works through contract revisions with Payors. 3. Routinely monitor current contracts for appropriate rate structure, contract terms and annual renewals and/or re-negotiations and compliance with industry standards and guidelines. 4. Monitor marketplace for new contracting opportunities and make recommendations of changes to enhance Covenant contract portfolio. 5. Coordinate implementation of Payor arrangements and provide ongoing education and support throughout Covenant. 6. Collect and communicate relevant contractual requirements and issues to internal customers such as Utilization Management, Finance, Patient Billing, Administration, Legal, etc. Information includes; payor relationships, operational requirements and contract terms. 7. Maintain comprehensive files of Covenant contractual relationships and update contract information in the contract database. 8. Maintain contract summaries on Covenant website 9. Act as liaison between Covenant and Payors on contracting and operational issues, i.e. billing, utilization review, credentialing site visits, notification of site closures or new services. 10.Coordinate facility credentialing and re-credentialing. 11.Perform other duties as assigned.
Other information:
EDUCATION/EXPERIENCE REQUIRED:
NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.
I t has been determined that Covenant HealthCare cannot provide a latex safe or latex free work environment at any of its facilities. Unfortunately, that means that any individual, including an applicant or an employee, is likely to be exposed to latex while on Covenant’s premises. Therefore, latex tolerance is considered to be an essential function for any position with Covenant.
