Job Title: Contract Management Liaison

FLSA Status: (Exempt)

Salary Range: See Pay Scale

Job Summary: Under the supervision of the Finance Director, the Contract Management Liaison is responsible for processing medical specialist and vendor contracts. Liaison for medical specialist for review of claims to ensure payment is processed according to contract agreement. This individual will also be the backup for the Finance Analyst.

Education: Associate degree in accounting, business, healthcare or related field.

Experience: At least 1 years experience working with the frail elderly population. 2 years Medicaid/Medicare knowledge with at least 2 years of accounting experience in a medical practice or equivalent business office setting. Experience in a healthcare setting working with medical claims.

Number and Type of Employees Supervised (optional): None.

Licensure, Registry or Certification Required: NC driver’s license.

Special Training: Meet a standardized set of competencies for the specific position description established by Senior TLC, Inc. and approved by CMS before working independently.

Immunizations: Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact

Ages of Patients Rendered Care:

Neonate/Infant Early Childhood Adolescent Adult Geriatric All Age Groups

• Supports Senior TLC’s mission to encourage and support the quality of life of seniors wishing to continue living in the community; its vision to be the preferred provider of individualized care for seniors in the community; and its values of respect, integrity, accountability, compatible goals, and compassionate care.
• Provides administrative support for the Director of Finance in being the Liaison for the Pace Program.
• Liaison for Contract Provider Request forms submitted by COO & Medical Director.
• Oversees and maintains the credentialing of all provider and vendor contracts.
• Oversees the Preclusion list of FDR (First Tier Downstream) & related entities to ensure compliance with CMS.
• Assists in conducting annual contract audits.
• Assists in conducting new provider and vendor orientations.
• Maintains contract/vendor files and database.

• Submits contract provider list for annual participant newsletter.
• Maintains and load new contracts within the claims adjudication software.
• Review weekly Pend Reports for contractual requirements for claims adjudication.
• Assists with the internal audit process of claims adjudication software.
• Review claims financial data utilization for contract negotiations.
• Report new contract providers to third-party payer for authorizations.
• Acts as Liaison with local DSS to ensure compliance with State regulations.
• Serves as a backup for the Finance Team as necessary.
• Other duties as assigned by the Director of Finance and Executive Director