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Contract Analyst

Atrilogy Solutions Group, Inc.

This is a Full-time position in San Antonio, TX posted April 8, 2021.

Atrilogy’s direct client is seeking a Contract Definition Analyst for a 6+ month contract. This position is 100 Remote. RESPONSIBILITIES bull Researching, defining, and maintaining reimbursement rules and supporting data tables for use in hospital contract management software bull Developing methods (logic) for accurately valuing inpatient outpatient claims with a focus on Medicare valuations bull Answering valuation-related support tickets from clients bull Analytical skills, Focus, Accuracy, and Timeliness are paramount qualities bull Research and define evaluation logic primarily for Medicare hospital claims valuation, with some commercial logic on occasion as well bull Locate and research CMS hospital-reimbursement websites and occasionally commercial payer websites for adjudication rules bull Download provider manuals, reimbursement policies, and medical policies for use in hospital and applicable commercial payer valuations bull Create and maintain a schedule of download frequencies necessary for timely and accurate valuation of claims – maintain a schedule for updates bull Manipulate fee schedules for loading into the contract management software program bull Provide internal consulting for enhancement of Hospital Claims Scrubbing application bull Review client claims to verify accuracy of claims valuation bull Attend and participate in internal and client meetings as needed bull Engage in process and quality improvement activities to minimize manual efforts QUALIFICATIONS bull Bachelor’s degree or greater in related field, or equivalent combination of education and experience bull Minimum of 3 years’ experience working in the hospital industry bull Hospital billing andor claims management background preferred bull In depth first-hand knowledge of Medicare adjudication methods for Inpatient and Outpatient hospital claims bull Demonstrated knowledge of coding conventions the function of each DRG Codes, Revenue Codes, Occurrence Codes, ICD-10, CPT and HCPCS codes bull Knowledge of the various types of health insurance payers Medicare, Medicare Advantage Plans, Commercial plans, Medicaid, and Medicaid Managed Care Organizations bull Broad range knowledge of different types of providers, including facility versus non-facility-based valuations bull Demonstrating overall healthcare reimbursement knowledge by obtaining satisfactory results on a Reimbursement Exam DESIRED SKILLS AND QUALITIES bull Engaging in deductive reasoning and critical thinking bull Exhibiting very strong attention to detail and accuracy, which is of paramount importance for role bull Demonstrating excellent skills in database platforms (Excel, Access, etc.) bull Working well in a team-oriented structure to achieve goals bull Meeting short deadlines while working independently, without supervision bull Analytical skills, Focus, Accuracy, and Timeliness are paramount qualities For immediate consideration please submit your resume in Word format, along with daytime contact information. LOCAL CANDIDATES ONLY. Client is unable to provide H-1B Visa sponsorship at this time. All submittals will be treated confidentially. Selected candidate may be asked to pass a comprehensive background, credit andor drug screening. Principals only, no third parties please. Atrilogy Solutions Group, Inc. (est. 2000), in partnership with Peak17 Consulting (est. 2008), provides organizations of all sizes with high-quality, cost effective information technology (IT) staffing services. Atrilogy has been recognized by Inc. magazine as one of the nation’s fastest-growing, privately held companies. Headquartered in Irvine, California, Atrilogy also has offices in Denver, Phoenix, Atlanta, and Dallas with satellite offices in Boston, Jersey City, Las Vegas, Seattle, and Delhi, India. Clients turn to Atrilogy for expertise in IT staffing and placement such as Project Managers, AgileScrum Masters, Business Analysts, DBAs, Software Engineers, Mobile Developers (iOS, Android), DevOps, Automation, QA, Systems Network Engineers, Cyber Security Information Security Specialists, ERP, CRM, Business Intelligence, Data Warehousing, Big Data and Creative (UIUX, Web Design) Clients turn to Peak17 for expertise in Operational staffing and placement of AccountingFinance, Human Resources, and Marketing professionals, as well as Information Technology resources. Atrilogy Solutions Group and Peak17 Consulting are Equal Opportunity Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, gender expression, national origin, protected veteran status, or any other basis protected by applicable law, and will not be discriminated against on the basis of disability. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. MEB Mandy Bargas Office 23052-H Alicia Pkwy, Suite 620 Mission Viejo, CA 92692

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