Contract Compliance Analyst III

Abbott Laboratories•Madison, WI

6d•$61,300 - $122,700•Remote

About The Position

The Contract Compliance Analyst III facilitates contract implementation and revenue pull-through activities with internal and external parties, ensuring public and private payer reimbursement. The role reviews billing and payment processes for efficiency, timeliness, and compliance with corporate goals, contracts, and regulations. The analyst manages contract implementation for operations and partners with Managed Care to develop and maintain agreements that provide medical providers and patients access to assays while aligning with organizational goals. This is a remote position, and candidates must reside in Wisconsin.

Requirements

At least 3 years of experience in billing/reimbursement, coverage, claims, and appeals.
Demonstrated understanding of public and private Managed Care payers and reimbursement processes.
Demonstrated understanding of market-related issues, contract basics, product coverage, and pull-through rationale.
Proficiency with Excel and Epic or a similar database, with the ability to maintain competency.
Ability to perform the essential duties with or without accommodation.
Strong attention to detail and organizational skills.
Strong analytical skills and ability to make recommendations supported by analytical evaluations.
Ability to drive results with a strong emphasis on quality.
Ability to prioritize and multitask, and to apply feedback professionally.
Excellent written and verbal communication skills across internal and external personnel.
Ability to collaborate and work effectively as a team member.
Ability to work on a mobile device, tablet, or computer screen and type for approximately 90% of a typical working day.
Ability to use a computer and phone simultaneously and to use a telephone through a headset.
Must be currently authorized to work in the country where the work is performed; employment visa sponsorship is unavailable.
Must reside in Wisconsin.

Nice To Haves

Knowledge of and/or experience with government Managed Care payers.
Knowledge of billing and coding.

Responsibilities

Develop communications about contracts, amendments, and notifications for internal Revenue Cycle Team customers, and collaborate with the Field Managed Care team on payer negotiations for operational optimization.
Contribute to developing and maintaining a contract database and contract management system in collaboration with credentialing and legal teams.
Work with finance and analytics to identify and address negative revenue pull-through scenarios for individual payers and payer segments, including Medicare Advantage, Blues, and Medicaid.
Collaborate with Revenue Cycle Team managers and specialists to build relationships with billing operations staff and payers and resolve contractual and non-contractual claim adjudication issues.
Support execution of pull-through plans to meet quarterly and annual revenue recovery goals.
Identify broad revenue opportunities across customer segments, including using Content Management Systems for noncontracted Managed Medicare non-payments and the Employer Coalition initiative.
Consistently identify opportunities to recover revenue.
Work with the Managed Care team to identify and prioritize plans and key payers for targeted efforts to influence coverage policy decisions.
Facilitate early conversations with appropriate personnel during the contracting process to provide account overviews and help avoid implementation delays.
Uphold company mission and values, support Quality Management System policies and procedures, maintain regular and reliable attendance, and model an inclusion mindset.
Work the designated schedule and perform computer, phone, and typing tasks as required.