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Managed Care Negotiator

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POST DATE 9/8/2016
END DATE 11/3/2016

RTI Conshohocken, PA

Company
RTI
Job Classification
Full Time
Company Ref #
90988-en_US
AJE Ref #
576115314
Location
Conshohocken, PA
Job Type
Regular

JOB DESCRIPTION

APPLY
Reimbursement Technologies, Inc. is a premier ER physician billing company a subsidiary of Envision Healthcare. We are located right outside of Philadelphia in Conshohocken, PA. We are currently looking for a full time Managed Care Negotiator. We were founded in 1991 to provide comprehensive service oriented billing and financial management services primarily to emergency room department physicians. Since then, RTI has grown into a 900+ employee firm that processes the billing for over twelve million emergency patients annually for physician in over 42 states.



Reimbursement Technologies, Inc. is a premier ER physician billing company located right outside of Philadelphia in Conshohocken, PA. We are currently looking for a full time Managed Care Negotiator. We were founded in 1991 to provide comprehensive service oriented billing and financial management services primarily to emergency room department physicians. Since then, RTI has grown into a 900+ employee firm that processes the billing for over thirteen million emergency patients annually for physician in over 42 states.







Major Responsibilities:







* Negotiate contracts between the company's physician groups and managed care organizations.

* Develop and maintain managed care, reimbursement and regulatory expertise.

* Evaluate and prioritize the contracting process with managed care entities based on the contract origination, i.e., hospital administration, EmCare's Regional Leadership, or direct third party payor contact.



* Create comparative analysis between current practice revenue and repriced revenue as well as performing financial analysis using proposed and recommended reimbursement rates.

* Facilitate the legal review of contracts and ensure appropriate feedback is provided.

* Provide financial participation recommendation (i.e., accept, reject, or counter offer at specific reimbursement levels) to EmCare's Regional leadership based on financial analysis and industry expertise.

* Update and track progress of contract negotiations via managed care database.

* Review and edit contract language to ensure proper billing articles and terminology has been incorporated.

* Provide RTI operational support by disseminating necessary information to various departments to ensure accurate billing of claims for executed managed care agreements.

* Perform post-implementation audits of payor's Explanation of Benefits (EOBs) to ensure contract compliance.

* Perform reimbursement analysis for special departmental projects as needed.











Job Requirements:







* A Bachelor's degree from a four-year college or university in a business or healthcare related field.



* Two to three years experience in financial analysis and payor/contract negotiations.

* Experience in Emergency Room management helpful.



* Need a solid background in Part B reimbursement.

* Excellent oral and written skills.



* Proficiency in utilizing spreadsheet software.



* Good organizational and interpersonal skills in order to interact with upper level management.



* Able to prioritize duties and goals of the department.



* Able to work under pressure and with deadlines.







We offer a comprehensive benefits package that includes:



* Medical, Dental, Vision and Prescription benefits available the 1st of the month after 60 days of employment.

* Matching 401(k)

* Tuition Reimbursement after 1 year of service.

* Septa Discount (monthly pass)

* 3 weeks paid vacation

* Paid Holidays and Sick Time

* Company paid life insurance and Long term disability Insurance