MEDLINE INDUSTRIES Healthcare Payer Contracts Administrator - Analyst in Northfield, Illinois

This job was posted by https://illinoisjoblink.illinois.gov : For more information, please see: https://illinoisjoblink.illinois.gov/ada/r/jobs/5095114 Responsible for administrating Medline's third party payer contracts programs including those involving Medicare Part B. Medicaid, and other government or commercial payers.nn


+ Initiate credentialing and maintain re-credentialing and re-validation of provider within the payer networks.

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+ Analyze and report on customer data

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+ Manage the payer contracting process from application to implementation.

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+ Manage payer/provider data base with SAP and Triage software. Maintain current payer files and other records in accordance with HIPAA Compliance, Company instructions and requirements.

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+ Collaborate and communicate with relevant functional groups (Billing & Reimbursement teams, Customer Service, Finance, and Regulatory) throughout contracting process to provide updates, discuss potential operational issues, develop and follow up on related action steps.

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+ Conduct pricing and profit/loss analysis in accordance with fee schedules.

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+ Assist in regular analysis of contracting needs including the assessment of utilization data to identify areas for new and re-negotiated contracts.

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+ Review, prepare and assist RVPs/SVPs in the RFP process.

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+ Provide support to other departments to ensure compliance with corporate contracting standards (i.e. Operations, Regulatory, etc.).

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+ Interact directly with Third Party Payers and Vendors as needed for issues relating to contracting, reimbursement, EFT and portal access/setups. Participate in provider orientations with Managed Care Payers.

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+ Actively pursue new payers at a local level. Distribute program sales materials to outside sales representatives.

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Medline offers a business casual, entrepreneurial work environment with strong growth potential, a competitive compensation package, and a complete benefits package including medical/dental/vision/life insurance; 401(k) with company match. And much more!

VEVRAA Federal Contractor

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