RCM CONTRACT MANAGER
Location: HYBRID – HOUSTON, TX
Salary range – $60k-$85k Annually
About The Company
Infinx Healthcare is a leading healthcare technology solutions company that supports revenue cycle management for providers and hospital systems, which has been continuously changing the landscape of healthcare delivery.
Driven by focus and an entrepreneurial mindset, Infinx is a fun, fast-paced company that is disrupting the patient access and revenue cycle management markets within healthcare with our SaaS, BPaaS and Services products. We provide tech-enabled service solutions that leverage machine learning and artificial intelligence to provide a cloud-based platform and solutions for our customers. We are looking for passionate people to continue to bring new ideas and innovations to our team.
We are looking for a contract manager with rich RCM experience in understanding Insurance/Payer contracts with large medical groups who wants to be part of an exciting, growing company that is a leader in the Revenue Cycle Management (RCM) space!
About The Role
The RCM Contract Manager is responsible for ensuring Revenue Cycle contracts are interpreted and maintained accurately and timely for all new and existing clients. This position requires skill sets in reviewing more than 50+ payer contracts, organize, follow-up with practice management team and credentialing team when a renewal or revisions occur. Radiology experience is preferred.
- Access all the contracts located in a secured location/servers
- Interpret each contract and then capture all relevant information like listed below
- Terms of reimbursements
- Effective date / Term date of contracts
- Payment values by modality, state and Tax ID
- MPPR or any other payment rules that apply
- Pull payer online fee schedules at least annually and more frequently for selected payers such as Blue Cross / Blue Shield where revisions happen more than once a year
- Access additional portals like Availity, Noridian or any allied portals that gather as many fee schedules as possible to have it compared with the existing contracts
- Work with Practice management software team to update Contract profile templates which will then be used to bill out claims at the accurate contract value.
- The templates should be sent for review/approval with copy of rates section, fee schedule documents, links and all appropriate reference materials
- Maintain working tracking document
- Maintain and file contract documents referred to for loading in secured servers for team to access
- Undergo training on Radiology Information system or RIS to access plan names and compare it against the plans loaded in billing software
- Any Insurance that are not in system and warrants a new profile to be created, will have to be reviewed and presented to RCM executive leadership for sign off and approval
- Adding to the Insurance profiles also keep track of self-pay, cash-pay promo, self-pay discount profiles by region and Tax ID and frequently present it to RCM executive leadership for review and sign off
Other Duties as Assigned
- Profound knowledge in RCM process flows
- Proficient in researching and swiftly acting to priorities coming his/her way
- Present the findings at regular cadence with small or large forums
Specific Skills Needed To Perform
- Profound knowledge on various RIS/EPM (preferably in Imagine)
- Hands on with tools like MS office applications
- Register / enroll in various portals to keep up-to-date on constantly evolving healthcare policies and procedures
- Ability to establish and maintain effective working relationship as required by the duties of the position
- Excellent written and oral communication skills
- Ability to come up with creative ideas to solve the problems on contract management
To apply, please send resume directly to firstname.lastname@example.org.