Medicare/Medicaid Billing Specialist and Contract Negotiator

Job Type: Full Time Job Category: IT Job Description Job Title: Medicare/Medicaid Billing Specialist and Contract Negotiator Job Summary: We are seeking a skilled and detail-oriented individual to join our team as a Medicare/Medicaid Billing Specialist and Contract Negotiator.
The successful candidate will be responsible for managing and optimizing the billing process for Medicare and Medicaid claims.
Additionally, they will utilize their negotiation expertise to handle contract negotiations and maintain beneficial business relationships with our partners and suppliers.
Responsibilities and Duties: 1.
Manage the billing process for Medicare and Medicaid claims from start to finish.
2.
Ensure accuracy and compliance with all regulatory requirements for reimbursement.
3.
Handle claim denials, rejections, and appeals, working closely with insurance companies and government agencies.
4.
Maintain comprehensive knowledge of Medicare/Medicaid regulations and requirements.
5.
Monitor and analyze billing reports to identify areas for improved efficiency and accuracy.
6.
Collaborate with cross-functional teams to resolve any billing-related issues.
7.
Serve as the main point of contact for contract negotiations with partners and suppliers.
8.
Develop and maintain positive business relationships with contracting parties.
9.
Research and analyze market trends to identify opportunities for favorable contracts.
10.
Negotiate payment terms, pricing, and other contract terms to ensure beneficial agreements.
11.
Review and revise contracts to maintain compliance with changing regulations and business needs.
12.
Collaborate with legal counsel to ensure contracts are legally binding and strategically advantageous.
13.
Maintain accurate records of all contract negotiations, amendments, and related correspondence.
14.
Provide recommendations on contract strategies to maximize profitability and mitigate risks.
15.
Keep abreast of industry developments, policy changes, and reimbursement trends.
Qualifications and Skills: 1.
Bachelor’s Degree in Healthcare Administration, Business, or a related field (or equivalent experience).
2.
Proven experience in Medicare and Medicaid billing procedures, including claim submission, denial management, and appeals.
3.
In-depth knowledge of Medicare/Medicaid regulations, coding procedures, and reimbursement guidelines.
4.
Strong negotiation skills and the ability to achieve win-win outcomes in contract negotiations.
5.
Exceptional attention to detail and accuracy.
6.
Proficient in using billing software and electronic health records systems.
7.
Excellent communication and interpersonal skills.
8.
Ability to work collaboratively in a team environment.
9.
Strong analytical and problem-solving abilities.
10.
Knowledge of the U.
S.
healthcare system and reimbursement processes.
11.
Familiarity with legal contracts and terminology.
12.
Ability to manage multiple priorities and meet deadlines.
13.
Strong time management and organizational skills.
14.
Proactive approach in identifying and resolving billing and negotiation issues.
15.
Understanding of governmental regulations related to healthcare billing and contract negotiations.
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