Contract Analyst

Job Description

Job Title:  Contract Analyst

Location:  San Antonio, Texas

General Summary of Duties:  This person has responsibility for analyzing, defining, loading, and testing client contracts in Phynanceâ„¢.  As a Contract Analyst, the candidate will be expected to research, analyze, and maintain contract data as well as create and maintain client documents. 

Supervision Received:  Reports to the Contract Definition Manager.

Essential Functions:

·  Review, analyze, and define managed care contracts.

·  Complete an MPV contract worksheet according to the current contract terms provided by the Client.

·  Make preliminary calls and/or e-mails to contracting entity contacts in order to notify them of forthcoming Contract Worksheet and Agency Letter.

·  Create/Maintain a preliminary Contract List in the Phynance Contract Module.

·  Request, pursue, and thoroughly analyze contract information from contracting entities for each identified contract throughout the implementation process.

·  Define, load, and test contract variables.

·  Create mapping table which relates the MPV contract code to the appropriate practice management system (PMS) contractual identifier(s) and forward to Development.

·  Notify Contract Quality Assurance that contract definitions are ready for verification.

·  Prepare MPV Contract Code List to be utilized during EOB Analysis training and e-mail to Training Department.

·  Acts as a resource for questions related to valuation accuracy and/or additional technical issues that may arise during the contract quality assurance and/or claim data reconciliation processes.

·  Assist in the development of policies and procedures for contract definition.

·  Attend and participate in internal and client meetings (as needed).

Education and Experience: Bachelors degree preferred or equivalent education and experience. Minimum 3 years experience working in the healthcare industry, specifically with managed care organizations or providers.

 

Knowledge/Skills:

·  Strong interpersonal and communication skills, capable of documenting and relaying information regarding complex topics, making presentations to an internal audience and interacting positively with MPV client base and associates.

·  Strong understanding of various reimbursement methodologies (including RBRVS, St. Anthony’s RBRVS, McGraw-Hill RVS, etc.).

·  Understanding of Network, IPA, MSO, PCP and Contract affiliations that pertain to client specific contracts.

·  Independent problem solving and self-direction are critical.

·  Strong attention to detail and accuracy required.

·  Advanced PC skills, with proficiency in utilizing Microsoft office products (Word, Excel, Outlook, PowerPoint, etc.).

·  Capable of understanding and using the Phynance application.

·  The ability to embrace change, be flexible, and project oriented.

·  The ability to work in a very fast paced environment.

·  Works well in a team oriented structure to achieve goals.

Compensation/Benefits:

·  A competitive compensation package will be provided. Benefits include a comprehensive medical and dental plan, STD/LTD, life insurance, cafeteria plan, a 401(k), stock options and vacation policy.