SUMMARY

Under the strategic direction of the Vice President of Payor Contracting, the Reimbursement Financial Specialist will oversee the collection, management, financial modeling and review of Managed Care/Payor Fee Schedules.  

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Work with VP and Managed Care Contracting team to provide tracking and management of the EyeCare Partner’s associated fee schedules.  
• This will include oversight and on-going management of payor fee schedules, including working with ECP Revenue Cycle Management to obtain training and access to payor’s claim system to obtain provider fee schedules.
• In collaboration with the VP of Payor Contracting and the Regional Directors, prioritize the payors, needed CPT codes and develop, implement and maintain processes to update the fee schedules annually.  
• Create reports for VP and team performing renegotiations to initiate renegotiation as applicable.
• Provide assistance to obtaining necessary CPT codes to support negotiations in a timely and collaborative manner. 
• Assist with payor contract financial modeling and scenario development.
• Provide support to the Revenue Cycle Management team on fee schedules using the identified CPT codes and on a priority/adhoc basis as needed.  
• Data management and obtaining appropriate and necessary documentation. 
• Perform other work-related duties as assigned.

QUALIFICATIONS

• 1+ years experience in a data management or analytical role
• Knowledge of medical billing/collection and/or insurance agreements helpful  
• Detail Oriented, self-motivated, eagerness to learn and research 
• Ability to work under pressure and remain friendly and professional
• Excellent time management skills and the ability to prioritize work
• Strong attention to detail and problem solving skills

EDUCATION AND/OR EXPERIENCE

• Bachelor’s Degree in Business, finance, health care management or related discipline, or combination of education and experience. 

SYSTEMS AND TECHNOLOGY

• Intermediate to Advanced skills in Microsoft Excel
• Power BI a plus

LOCATION

• Candidates must live in: Alabama, Arizona, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Missouri, New Jersey, N. Carolina, Ohio, Oklahoma, Pennsylvania, Texas and Virginia to be considered.  

NOTE:  Job descriptions are intended to be accurate reflections of those principal job elements essential for making fair pay decisions about jobs. Nothing in this job description restricts management right to assign or reassign duties and responsibilities to this job at any time.

If you need assistance with this application, please contact (636) 227-2600. Please do not contact the office directly – only resumes submitted through this website will be considered.

EyeCare Partners is an equal opportunity/affirmative action employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.