Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.
The Contract Management Coordinator is responsible for monitoring third party payments for accuracy based on contracts and payer rules. The Coordinator is responsible for tracking and trending payment accuracy by payer and providing feedback to the Administrative Director of Reimbursement and others as necessary. The Contract Management Coordinator demonstrates integrity and reliability and serves as the department leader in an attentive, courteous and competent manner.The Contract Management Coordinator is entrusted to set a positive tone for all interactions. The Coordinator is a lead position and will oversee processes designed to reduce decrease payment variations. The Coordinator demonstrates the ability to be a self motivated, energetic person who can interact with third party payers in a courteous manner; maintaining a positive attitude and remaining calm under pressure; and demonstrates collaboration with departments throughout the organization to develop tools and make recommendations for improving internal processes that will reduce payment variations.
Required Qualifications:
- Minimum of three years’ experience in healthcare as a licensed clinical contributor
- High School diploma or GED
- Thorough knowledge of Revenue Cycle processes and standards related to coding, billing, and reimbursement.
- General knowledge of patient registration and finance.
- Knowledge of regulatory requirements related to patient accounting, including a solid understanding of Medicare, Medicaid and managed care processes.
- Ability to identify trends and root causes as well as the ability to communicate the findings.
- Ability to set and maintain priorities when dealing with multiple demands and interruptions.
- Strong analytical and problem solving skills.
- Intermediate computer skills including email, word processing, spreadsheets, and working with graphics. Knowledge of medical terminology.
Preferred Qualifications:
- Additional coursework in business administration, health care administration, accounting, and/or personnel management
- Experience with Cerner Millennium
Duties and Responsibilities:
- Identifies payment variances between expected reimbursement and actual reimbursement
- Tracking and trending payment accuracy by payer and providing feedback to the Administrative Director of Reimbursement and others as necessary
- Ensures goals and objectives are established and attained
- Documents relative information on patient accounts as per SJRMC protocol.
- Ensuring the Contract Management system is accurate, current, and fully utilized
- Participate in committees and task forces as needed
- Respond personally to concerns and/or complaints expressed by patients, visitors, hospital staff, and physicians in effort to support optimal operations and excellent customer service.
- Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers.
- Ensure compliance with hospital policies and standards, safety, environmental and infection control policies and procedures.
- Each employee is responsible for implementing SJRMC’s Service Standards into their daily work. Safety, Courtesy, Effectiveness, and Stewardship
- Other duties as assigned
Physical Demands and Environmental Work Conditions:
- Must be able to walk, sit, and stand for long periods of time
- Must be able to work under stress
- Vision and hearing acuity must be within normal range
Identifies payment variances between expected reimbursement and actual reimbursement. Tracking and trending payment accuracy by payer and providing feedback to the Administrative Director of Reimbursement and others as necessary. Ensures goals and objectives are established and attained. Documents relative information on patient accounts as per SJRMC protocol. Ensuring the Contract Management system is accurate, current, and fully utilized. Participate in committees and task forces as needed. Respond personally to concerns and/or complaints expressed by patients, visitors, hospital staff, and physicians in effort to support optimal operations and excellent customer service. Ensure compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers. Ensure compliance with hospital policies and standards, safety, environmental and infection control policies and procedures. Each employee is responsible for implementing SJRMC’s Service Standards into their daily work. Safety, Courtesy, Effectiveness, and Stewardship Other duties as assigned.
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