Position Summary: Responsible for reviewing, negotiating, and maintaining payer contracts with all insurance companies accepted by the hospital. This position also posts insurance remittances, responds to patient billing inquiries, and processes payments received by telephone.
Essential Duties and Responsibilities:
• Analyze, negotiate, and renew managed care and payer contracts to ensure favorable reimbursement terms and compliance with hospital objectives.
• Develop and maintain productive relationships with insurance representatives and monitor contract performance.
• Post insurance remittances accurately and reconcile payment variances.
• Respond professionally to patient inquiries regarding billing, insurance coverage, account balances, and payment arrangements.
• Accept and process patient payments by telephone in accordance with hospital policies and payment security requirements.
• Maintain accurate records of contracts, correspondence, and billing activities.
• Collaborate with leadership to identify reimbursement opportunities and resolve payer issues.
Additional Duty:
• Perform other duties and responsibilities as assigned by the supervisor or management team.
Qualifications:
• Demonstrated experience in insurance contracting and payer negotiations, preferably in a hospital setting.
• Knowledge of healthcare reimbursement methodologies, managed care agreements, and revenue cycle operations.
• Excellent communication, customer service, and organizational skills.
• Proficiency with healthcare billing and accounting systems.