Contract Administrator

Description

Medline Industries, Inc. has an immediate opening for a Contract Administrator in our Homecare division located in the Mundelein facility. The Managed Care Contract Administrator is responsible for administrating Medline's third party payer contracts programs including those involving Medicare Part B. Medicaid, and other government or commercial payers.

Position Responsibilities

• Initiate credentialing and maintain re-credentialing and re-validation of provider within the payer networks
• Distribute program sales materials to outside sales representatives.
• Manage the payer contracting process from application to implementation.
• Manage payer I provider data base with SAP and Triage software
• Participate in surveys conducted by authorized inspection agencies.
• Participate in Company committees when requested.
• Collaborate and communicate with relevant functional groups (billing & reimbursement teams, customer service, finance, regulatory) throughout contracting process to provide updates, discuss potential operational issues, develop and follow up on related action steps
• Review, prepare and assist RVPs/SVPs in the RFP process
• Maintain current payer files and other records in accordance with HIPPA Compliance, Company instructions and requirements
• Conduct pricing and profit/loss analysis in accordance with fee schedules
• Assist in constant analysis of contracting needs including the assessment of utilization data to identify areas for new and re-negotiated contracts
• Provide support to other departments to ensure compliance with corporate contracting standards (i.e. Operations, Regulatory, etc.)
• Participate in provider orientations with Managed Care Payers
• Interact directly with Third Party Payers and Vendors as needed for issues relating to contracting, reimbursement, EFT and portal access/setups
• Actively pursue new payers at a local level
• Participate in Company committees when requested.
• Report any misconduct, suspicious or unethical activities to the Compliance Officer.
• Perform other duties as assigned by S.V.P. of Home Care Operations, Compliance Officer and I or President of Home Care Sales and Reimbursement Services.

Qualification

1. Minimum of 3-5 years of credentialing and contracting
2. Ability to organize and plan the activities related to customer maintenance.
3. Organizational skills sufficient to maintain consistently accurate records.
4. Experience with customer service or business administration.
5. Computer skills that include MS Word, Excel, and efficient use of the internet and e-mail
6. Possess excellent research skills
7. Pursue continuing education programs appropriate to job responsibilities.
8. Detailed understanding of contractual agreement language and amendments
9. Understanding of Medicare, Medicaid and Commercial payers, its rules and reimbursement