Rotech Healthcare Inc. Contract Administration Specialist I in ORLANDO, Florida
YES, Rotech is still hiring to help serve our patients during this time of the COVID-19
As your Home Respiratory and DME equipment and services provider, our number one priority is the safety of our patients and our employees. PPE is provided to all of our employees that will have contact with patients.
We have implemented the following measures:
We are maintaining social distancing of at least 6 feet in both the workplace and during home delivery/pickup, whenever possible.
We are asking patients to complete a screening questionnaire to determine high-risk situations for our employees.
We have enhanced cleaning procedures for all of our equipment.
We are communicating frequently with our employees regarding the latest guidance from the CDC.
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
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
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
- Office environment
Career Path and Management Opportunities
Employee Discounts, Referral Bonus, Recognition Program and Employee Service Program
Cell Phone reimbursement (when applicable for the position)
Mileage reimbursement (when applicable for the position)
Medical, Prescription, Dental and Vision plans
Flexible Spending Account and Health Savings Account
Short Term and Long Term Disability
Supplemental Life Insurance
Employee Assistance Program
Paid Time Off and Paid Holidays
Make the right move, create your job profile and apply today!!
The hiring manager will review your resume and contact you if your qualifications match our needs. We appreciate your interest in Rotech Healthcare Inc.
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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.
Requisition ID: 2020-8307
Street: 3600 VINELAND ROAD
Street 2: SUITES 114
External Company URL: www.rotech.com