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OneOncology · 19 hours ago

Contract Adherence Specialist

United States

Full-time, Contract

Remote

Senior Level

5+ years exp

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model. The Contract Adherence Specialist will manage and maintain fee schedule related aspects of Payer Reimbursement, ensuring accuracy in contracted fee schedule data and resolving underpayment issues.

Health CareOncology

Growth Opportunities

Responsibilities

Knowledgeable and proficient in Claims billing procedures CPT and HCPCS codes

Demonstrates and applies expert level of knowledge of revenue cycle processes and concepts

Interpret contract reimbursement

Maintains documentation for contractual reimbursement for payers

Maintains data in appropriate database

Evaluates actual reimbursement compared to defined contractual reimbursement rates for specific drugs/procedures

Performs account audits

Manages payer log spreadsheets to be submitted to the health plans

Identify trends in underpayments

Research and identify payment discrepancies from various sources

Performs reviews and assessments for underpaid claims

Compile and analyze data for recovery

Manage underpayment appeals and account follow-up

Resolve underpaid claims in an effective and timely fashion

Reports dollars and recovery efforts routinely to management

Additional responsibilities may be assigned to help drive our mission of improving the lives of everyone living with cancer

Qualification

Claims billing proceduresRevenue cycle processesCPTHCPCS codesData analysisWindows-based softwareOrganizational skillsAttention to detailVerbal communicationWritten communicationSelf-motivated

Required

High School diploma or equivalent required

Knowledgeable and proficient in Claims billing procedures CPT and HCPCS codes

Demonstrates and applies expert level of knowledge of revenue cycle processes and concepts

Interpret contract reimbursement

Maintains documentation for contractual reimbursement for payers

Maintains data in appropriate database

Evaluates actual reimbursement compared to defined contractual reimbursement rates for specific drugs/procedures

Performs account audits

Manages payer log spreadsheets to be submitted to the health plans

Identify trends in underpayments

Research and identify payment discrepancies from various sources

Performs reviews and assessments for underpaid claims

Compile and analyze data for recovery

Manage underpayment appeals and account follow-up

Resolve underpaid claims in an effective and timely fashion

Reports dollars and recovery efforts routinely to management

Attendance is an essential job function

Detailed knowledge of billing, HCPCS, CPT and ICD codes

Exceptional Multi-tasking, organizational skills and attention to detail

Works well under deadlines and time sensitive projects while maintaining accuracy

Strong numeric and analytical skills

Self-motivated, able to work autonomously, multi-task and switch focus quickly

Excellent verbal and written communication skills

Strong knowledge of Windows-based software applications (E.g. Word, Excel, Outlook, Access)

Must possess high degree of professionalism and adaptability

Preferred

Minimum five (5) years' experience in accounts receivable, healthcare, or managed care preferred

Previous collections experience preferred

Company

OneOncology

OneOncology is a partnership of oncologists and industry leading experts driving the future of community-based cancer care in the US. It is a sub-organization of General Atlantic.

Founded in 2018

Nashville, Tennessee, USA

1001-5000 employees