Corporate Agreement Specialist I

Fresenius Medical Care•Kennesaw, GA

5d•Remote

About The Position

THIS IS A REMOTE POSITION PURPOSE AND SCOPE: The Corporate Agreement Specialist supports Fresenius Medical Care's mission, vision, core values and customer service philosophy and adheres to the Fresenius Medical Care Compliance Program, including following regulatory and FME policy requirements. The specialist secures revenue to overall business through negotiation, execution and administration of Single Patient Letter of Agreements (non-insurance) with referral sources and when applicable to new admissions and existing patients across assigned regions and/or business units. In addition, the specialist secures out of network revenue by negotiating settlement agreements with health plans and third-party payors for prior services rendered. PRINCIPAL DUTIES AND RESPONSIBILITIES : Developing professional expertise; applies company policies and procedures to resolve a variety of issues. Normally receives general work instructions on routine work, detailed instructions on new projects or assignments. Work is reviewed for soundness. Manage all activities required to secure revenue through the process of negotiating individual Letter of Agreements and settlement agreements ensuring compliance with all regulatory and company guidelines and requirements. Initiate and complete Letters of Agreements for AKI or ESRD patients from a hospital (uninsured or has insurance with no dialysis benefits) as well as religious entities, permanent or seasonal self-pay patients or patients under the care of a hospice, rehab or psychiatric facility. Responsible for activities related to the negotiation and execution of Single Patient Letter of Agreements such as conducting market assessment and history prior to initiating the negotiation process, obtains necessary approvals if required for rates and terms, and notifies the Revenue Centers and CVO offices of completion. Review and resolve settlement proposals for past services rendered where Letters of Agreement from health plans were not obtained prior to patient admission. Lead negotiation efforts among commercial payors, self-funded employers, third party administrators, and repricing agencies. Review rate proposals and claims payment history to determine historical out of network payment trends by payors and to determine the most favorable outcomes/options. Facilitate the admission of patients into Fresenius dialysis clinics through prompt negotiations and administer the implementation of these agreements by communicating the financial terms pertinent to the terms of agreement to the supporting CVO offices and revenue centers allowing for timely and accurate billing for appropriate dialysis services rendered. Maintain an automated log to manage the requests for Letter of Agreements and settlement agreements by monitoring the progress of active requests and providing information to the departments regarding the status and completion. Work with Revenue Centers to assist with claim and payment issues with regards to processed Letter of Agreements or settlement agreements. May act as a liaison between Intake or CVO and Referral Sources to support the ongoing needs of the referred patient as needed. Supports all departments with regards to patients needs or general assistance with questions regarding Letters of Agreement. Possess a sense of urgency regarding performance of assigned tasks Other duties as assigned PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

Bachelor’s Degree required or equivalent work experience.
2 – 5 years’ related experience; or an advanced degree without experience; or equivalent directly related work experience.
Strong understanding of insurance products, benefits, and billing knowledge.
Solid computer skills with advanced proficiency in word processing, spreadsheet and email applications.
Detail oriented with strong analytical and organizational skills.
Strong time management skills with the ability to multitask concurrent priorities in an organized manner.
Strong problem solving and time management skills with ability to consistently work in a fast-paced environment.
Strong interpersonal skills with the ability to work cohesively within a team and outside environments.
Strong oral and written communication skills to effectively communicate with all levels of management and outside sources.
Sense of urgency regarding performance of assigned tasks.

Responsibilities

Manage all activities required to secure revenue through the process of negotiating individual Letter of Agreements and settlement agreements ensuring compliance with all regulatory and company guidelines and requirements.
Initiate and complete Letters of Agreements for AKI or ESRD patients from a hospital (uninsured or has insurance with no dialysis benefits) as well as religious entities, permanent or seasonal self-pay patients or patients under the care of a hospice, rehab or psychiatric facility.
Responsible for activities related to the negotiation and execution of Single Patient Letter of Agreements such as conducting market assessment and history prior to initiating the negotiation process, obtains necessary approvals if required for rates and terms, and notifies the Revenue Centers and CVO offices of completion.
Review and resolve settlement proposals for past services rendered where Letters of Agreement from health plans were not obtained prior to patient admission.
Lead negotiation efforts among commercial payors, self-funded employers, third party administrators, and repricing agencies.
Review rate proposals and claims payment history to determine historical out of network payment trends by payors and to determine the most favorable outcomes/options.
Facilitate the admission of patients into Fresenius dialysis clinics through prompt negotiations and administer the implementation of these agreements by communicating the financial terms pertinent to the terms of agreement to the supporting CVO offices and revenue centers allowing for timely and accurate billing for appropriate dialysis services rendered.
Maintain an automated log to manage the requests for Letter of Agreements and settlement agreements by monitoring the progress of active requests and providing information to the departments regarding the status and completion.
Work with Revenue Centers to assist with claim and payment issues with regards to processed Letter of Agreements or settlement agreements.
May act as a liaison between Intake or CVO and Referral Sources to support the ongoing needs of the referred patient as needed.
Supports all departments with regards to patients needs or general assistance with questions regarding Letters of Agreement.
Possess a sense of urgency regarding performance of assigned tasks
Other duties as assigned