Reporting to the Contract Area Manager, the Contract
Area Representative will be responsible for following up on all outstanding
trips that relate to contacts with hospitals, agencies, health plans,
mental health, etc., as well as all capitated and
non-capitated contracts and managed care.
Essential duties and responsibilities include the
following. Other duties may be assigned.
* Work aging report on a monthly basis.
* Meet monthly production requirements.
* Respond to day-to-day changes in priorities, workload, assignments,
and take action to decrease accounts receivable and increase cash
collections.
* Review and interpret contract language to ensure the trips are pricing
correctly.
* Perform research and follow up on all trips over 90 days.
* Contact appropriate agent to verify eligibility.
* Review all assigned contracts queues and takes appropriate action
to resolve accounts.
* Answer incoming facility contract calls as well as patient calls
and take the appropriate action.
* Adhere to all company policies and procedures.
* Process contract correspondence and denials (facilities, hospitals,
health plans, and patients).
* Provide encounter data for capitated contracts.
* Participate in meetings with contracted hospitals, facilities, and
agencies regarding contract implementation, billing issues, etc.
* Communicate with prebillers, operation liaisons, operations, business
development regarding issues or problems with contracts.
* Perform special projects and audits of outstanding claims.
* Research and respond to inter-departmental correspondence (i.e.
Business Development), and Unable-To-Locate (UTL) checks.
Job Requirements
Minimum qualifications:
