Infusion Reimbursement Contract Specialist

Soleo Health Inc • Frisco, TX

69d • Remote

About The Position

The Reimbursement Contract Specialist supports Reimbursement Contract Management with research throughout the payor contract review process and in addition, provides guidance/trainings to stakeholders on existing and new payor contract information. This requires management of internal resources pertaining to contract reimbursement information within the company intranet site and a high level of written and oral communication with a broad range of stakeholders.

Requirements

• At least 4 years of experience with Home Infusion therapies and associated HCPC codes
• Must have experience with and thorough understanding of Payor Contracts (e.g. for audits, rate review/negotiation or reimbursement language review)
• Reimbursement experience (RCM related): Auditing/root cause analysis, financial analysis, Home Infusion billing (medical) or similar
• Advanced knowledge of medical insurance plans: Managed Care Organizations, Commercial, Medicare Advantage, Self-Funded, TPAs and providers at financial risk (hospital/health systems, medical group/IPA)
• Experience in creation of training material or procedures (SOPs) with ability to disseminate information regarding newly executed contracts to large groups
• Advanced knowledge of Home Infusion or Medical Specialty Pharmacy pricing/fee schedules
• High level of organization required, with proficiency in the Microsoft suite of products

Responsibilities

• Assists Reimbursement Contracts Manager in review of payor contracts and amendments.
• Provides consultation, education and training on payor contract requirements to Intake and Reimbursement teams.
• Provides timely and accurate information regarding payor reimbursement methodologies, rates and policies to stakeholders.
• Manages payor contract, reimbursement related resources and other payor-related documents on company intranet site.
• Prepares reports and assists with special projects.
• In collaboration with leadership, investigates payment variances for payor contract non-compliance.

Benefits

• Competitive Wages
• Paid Parental Leave Options
• 401(k) with a match
• Great company culture
• Referral Bonus
• Annual Merit Based Increases
• No Weekends or Holidays!
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) options
• Paid Time Off
• Education Assistant Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 251-500 employees