Remote Risk Adjustment Coder Jobs in Rochester, PA

Contract Analyst (Remote)

Contract Analyst is part of the NADG Resource Center that supports The Professional Dental Alliance (PDA), which operates 200+ dental practices in 15 states. Contract Analyst manages the overall DSO/Plan relationship and is the health plans primary point of contact at NADG. Contract Analyst is responsible for negotiation and management of contracts with dental insurance plans as well as the overall payer strategy on behalf of The Professional Dental Alliance. Contract Analyst serves as a resource to all areas of NADG and provides timely guidance on payer issues. Contract Analyst may act as an intermediary between other NADG departments and/or practices and the health plan in resolving non-routine issues once available options have been explored/exhausted by all parties directly involved.

Who YOU Are:As a Contract Analyst on the Payer Relations team, you will support the payer contracting team by performing analysis as needed, maintaining the contract management database, proposal modeling, cataloging contracts, fee schedule maintenance, and payment compliance as needed.  More specifically, you will:

• Analyze proposed rates by modeling and comparing reimbursement to determine contract value and potential revenue impact.
• Work closely with Accounting and BI teams to procure data from available sources and develop reports to be used by the Payer Relations department
• Perform timely entry of pertinent data into a contract management system or Matrix
• Maintain accurate Participation Matrix by state and clinic
• Maintain accurate TIN listing by state, practice, specialty
• Maintain Leased, Tiered and Stacked Network Matrix
• Proactively research payer policy changes that impact PDA/NADG
• Continuously monitor contract performance and value, identifying new targets for renegotiation or biennial contract adjustment (COLA)
• Assist with the entry of new rates into the Fee Schedule tables and perform regular maintenance of those tables
• Assist with yearly UCR fee increase projects as assigned
• Operate in compliance with all local, state, and Federal laws as well as NADG policy and compliance standards

Job description is not intended to include an inclusive list of responsibilities. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.

Qualifications

We are Excited About You if you have:- A Bachelor's degree in a healthcare, business, finance, or a related field.- 2-3 years-experience in provider relations, payer relations or financial analysis within a healthcare organization- May consider qualified candidates in lieu of a bachelor's with 7-9 years of directly related experience or relevant health care experience- Advanced Microsoft Office skills (Excel is a must), experience with Business Intelligence reporting preferred

- Understanding of key performance metrics and performance reporting- High attention to detail with ability to analyze and summarize data- Dental or Health insurance plan experience preferred but not necessary

- Knowledge of procedural coding systems as it relates to payer contracting is preferred but not necessary

Benefits Await!

We take pride in our ability to give our team members all the benefits they deserve. This is why we offer...

• Health, Dental and Vision Insurance (Full-time employees)
• Healthcare Spending Account
• Paid Time Off
• 401k
• Voluntary Life & Disability Insurance
• Referral Program
• Employee Discount Program

Equal Opportunity Employer

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, ancestry, religion, sex, sexual orientation, gender identity, age, national origin, disability, protected veteran status, or any other characteristic protected by law.

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