Senior Associate - PR Analysis

To accomplish contract administration, pricing & coding, extracting data and network system maintenance through the implementation of the agreed department action plans and rules to achieve system efficiencies within the agreed timescales.

• Implement the set contracts’ uniformity,standards and regulatory compliance with all providers.
• Coordinate the logestics of contracting new providers ,new service codes and the renewal of contracts.
• Ensure that all providers’ files and system data are completed and updated in consistency with all agreements and amendments filing of contracts.
• Update systems and follow up the expiration dates of the contracts within the agreed timescales.
• Review providers’ coding and remove redundant and duplicate codes of the providers.
• Monitor, regularly, the expiration of regulatory licensing of the providers to achieve timely renewals.

• Extract data necessary for benchmarking of services.
• Maintain updated master sheets for the benchmarks.
• Conduct price comparisons with the benchmarks whenever needed.

• Identify redundant and duplicate code to help the revamp of the coding system.
• Collect, regularly, statements’ data of invalid service codes and billing above agreed prices for resolution.
• Coordinate, internally and externally, for the resolution of coding and pricing default.
• Upload the new prices, contracts and amendments in the operating systems.
• Review the first 3 statements of providers with new price amendments to ensure providers’ compliance.
• Report, regularly, system and statement errors to the line manager.

• Ensure that network changes are updated in the systems.
• Monitor providers, physicians and service finder for website support and development.
• Maintain updated master sheet for providers network distribution.

• Extract referral data and reports to monitor the implementation of referral rules.

• Coordinate with the operating team and technical stakeholders to ensure the implementation of addition /deletion of contracts/providers, amendments and significant contract milestone.