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InfuSystem · 6 hours ago

RCM Associate Contract Modeler

Michigan, United States

Full-time, Contract

Onsite

Entry, Mid Level

2+ years exp

InfuSystem is a leading national health care service provider that facilitates outpatient care for durable medical equipment. The RCM Associate Contract Modeler is responsible for modeling contracts, maintaining payer terms, and analyzing reimbursement rates to support internal teams with reimbursement-related concerns.

Health CareMedical Device

Responsibilities

Assist with identifying payer issues and payment inconsistencies through reimbursement analysis processes

Has the ability to extract and interpret data from databases and reports

Ability to work both independently and with other departments on projects to gather data and provide meaningful findings

Update rejection codes monthly, or more frequently if necessary

Update Medicare and Medicaid reimbursement rates quarterly or on an as needed basis

Assist with payment analysis and update payer allowables multiple times per year

Payer additions and updates as requested by departments or required by payer changes

Create and maintain billing codes, procedure groups, allowable groups, etc. as needed

Load new payers or update existing payers according to contract terms

Remain up to date on payer medical policy notices and changes

Qualification

Healthcare experienceReimbursement analysisHDMSNikoHealthInsurance guidelinesICD-10CPTHCPCS codesAnalytical skillsProblem solvingTime managementAttention to detailOrganizational skillsEffective communication