Associate Consultant, Zero Balance (PRN)

Corrohealth

About The Position

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: Job Description Summary Account Executives are subject matter experts of zero balance projects, conducting in depth research of hospital contracts, data, and other sources to address client questions. They manage external project relationships, which includes compiling and presenting reports and analysis. They also manage internal projects and assignments.

Requirements

A minimum of 3 years of experience in areas of research and analysis
A minimum of 3 years of verifiable work history
A minimum of 3 years of experience with managed care contracts and hospital reimbursement
A minimum of 2 years of experience working with clients or equivalent
Must have achieved High School Diploma or GED
3 years of experience working in MS Office, with emphasis on advanced Excels skills, requiring experience with formulas, graphing, and reports to manipulate pricing tools and edit project reports
Demonstrated problem solving and critical thinking skills
Demonstrated ability to meet project deadlines
Demonstrated excellent written and verbal communication skills, to include writing professional documents and delivering presentations.
Diligent and strong attention to detail

Nice To Haves

Access: Update and link queries and tables, create steps to calculate reimbursement
Understanding the basics of MySQL (specifically: modification in a field or table- following field and data requirements)

Responsibilities

Manage client projects and relationships by participating in meetings, managing action items through to completion, answering client questions, and independently writing client emails
Compile, QA, and independently manage client processes from start to finish, such as provider relation escalations, bulk issues, regular reports, and invoices
Manage internal staffing and project needs, including answering questions from other team members on assigned client and monitoring project profitability
Research and determine next steps for complex and new payer issues and reimbursement areas to uncover potential opportunities, such as reimbursement guidelines and healthcare legislation
Create and update project plans, including outlining potential risk areas of a hospital-payer contract based on reimbursement structure and how to manually identify within the data
Review and summarize pricing documents based on hospital contracts to calculate expected payments, including Medicaid, percentage of charge, per diems, Medicare IPPS, MSDRG, outlier and/or stoploss, implants, drugs, and other reimbursement models
Make thorough client observations and recommendations after completing a project audit regarding underpayment exposure, contract risk, and other potential issues
Work with other account executives and managers to effectively submit bulk listings of accounts to insurance companies for reprocessing (e.g. rebill)
Escalate accounts to insurance provider relations for resolution and payment, including corresponding appropriately with provider relations teams, tracking progress of issues and ensuring that deadlines are met
Examine feedback from other internal teams on project activity and provide teams appropriate direction regarding account action when auditing and/or pursuing payments
Contribute meeting content to team meetings, AC biweekly meetings, and internal project related meetings
Help create and implement process improvements and trainings to protect future revenue
Understands and implements best practices for internal processes, communication, and documentation
Other duties as assigned