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SalaryWHO WE ARE:
AC3 was founded by practicing oncologists along with data and practice analytics experts to support the business side of medicine. Our mission is to modernize and digitize the delivery of healthcare and improve countless lives along the way.
We combine the power of big data technology and people to enable easier frontline decisions about complex problems. AC3 offers its employees an exciting, fast-paced, and challenging work environment. To learn more about AC3, visit us at www.ac3health.com.
COMPANY MISSION: To simplify healthcare and reduce the cost of care, empowering care givers to focus on what matters most – fighting cancer.
POSITION SUMMARY:
This is a hybrid position, meaning there are some onsite work requirements, so ideal candidates should be within a 2-3 hour commute radius. The Paer Contract Specialist is responsible for analyzing Payer Contract Terms & Reimbursement Methodologies. This includes interpreting Payer Contract language to create & maintain accurate Fee Schedules, identify opportunities for negotiations, & ensure Payment Integrity for all AC3 Clients.
Essential Function and Job Responsibilities
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Review Payer Contracts/Amendments and extract key information for the Payer Contract Matrix
- Interpret & Explain Payer Contract Terms to various stakeholders
- Provide guidance on reimbursement rates & the creation of Client Fee Schedules
- Perform Reimbursement Analysis utilizing AC3’s proprietary Contract Management Software
- Collaborate with AC3 Account Teams & Clients to ensure 100% of their Payer Contracts & Amendments are obtained, organized, & regularly updated.
- Effectively communicate Payer Contract improvement opportunities, internally & externally.
- Explain & Document all types of Reimbursement Arrangements (Fee-for-Service, Value-Based Arrangements, Capitation, etc.)
- Maintain up to date inventory of demographic information, NPIs, Tax IDs, etc. per Client
POSITION REQUIREMENTS
- Bachelor’s degree in business administration, Healthcare Administration, or similar program preferred or equivalent professional experience.
- Analytical & Detail Oriented a must.
- Proficient in Microsoft Excel, understanding of databases, & healthcare software systems
- Excellent oral & written communication skills
- Strong Project Management skills
- Minimum 3-5 years in a Payer Contracting role for Physician Practice(s) preferred. Other Revenue Cycle experience and/or experience with a health insurance company is also desirable.
- Ability to handle Payer Contract & Fee Schedule responsibilities for numerous different Clients simultaneously.
- Deep Knowledge & experience in reimbursement, contracting, & managed care operations
This is a remote/hybrid position with the expectation of travel to meet the needs of the position. Work is completed in a general office environment, sedentary in nature but may require standing and walking for up to 10% of the time. The work environment is favorable with adequate lighting and temperature, and no hazardous or unpleasant conditions caused by noise, dust, etc. Must be able to operate standard office equipment and keyboards.
Why Work at AC3?
When you become an AC3 Team member, you can expect ongoing training, support, and a work culture like no other. We offer our Full-Time Team Members medical, dental and vision health and wellness benefits, along with employer paid life insurance, long and short-term disability policies. Because our team’s health and wellness are our priority, we start new hires off with an above average paid time out plan and offer a comprehensive wellness program, including onsite biometrics and ongoing mental and physical wellness support. We also provide all Team Members with access to company sponsored financial wellness counselors, employee assistance services and the opportunity to enroll in our company-matched, 401k plan.
Come join our Winning Team!
