SynerMed Senior Analyst -Terms and Conditions in Monterey Park, California

About SynerMed

SynerMed is a market-leading healthcare organization specializing in government-sponsored programs headquartered in Monterey Park, California. SynerMed is dedicated to innovating healthcare through an integrated system of tools, purpose-built web platforms, and professional services that connect physicians, members, hospitals and health plans. SynerMed’s mission is to transform the healthcare system by rewarding high-quality and cost-effective care. For more information about SynerMed, visit www.synermed.com and www.synermedconnect.com.

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JOB DESCRIPTION SUMMARY:

The Terms & Conditions Senior Analyst will focus on all day to day operations of the Terms & Conditions Department. These duties will include

  • Managing work queues (Share, SharePoint and Reimbursement Folder), development of fee schedules for all provider/contract types, including entry and maintenance of all system overrides.

  • Maintenance and updating of the base governmental fee schedules, as well as the PCP Fee Schedules for each Client.

  • A critical part of your new role will be to maintain open communication channels with all key client contacts, to ensure that our fee schedules are customized to not only address state and federal regulations, but client specific needs, and to ensure that client needs are communicated clearly and accurately to all internal departments.

  • You will also work on developing the skill sets of the Terms & Conditions Staff, as well as checking all new contract setups for payment accuracy and correct contract interpretation.

Required Experience/Skills:

  • Must have Healthcare, Health plan or Managed Care/IPA industry experience

  • 3+ years of experience with “terms and conditions”

  • 2+ years of experience with Claims in the health care, health plan or IPA/Managed Care setting

  • Proficient in PC-based applications for data entry such as Microsoft Excel and Word

  • Experience using EZ-Cap modules such as health plans, hospital and professional claims modules.

Education:

  • High School Diploma

ID: 2017-1387