Assistant Manager - Managed Care Contracting

Job Type

• Create and maintain facility-specific calculators by identifying top commercial payers.
• Update calculators based on commercial rate changes and effective dates.
• Support Payment Posting team with ThoughtSpot reports and contract profile analysis.

• Load Medicare contracts quarterly and commercial contracts periodically in the Practice Management System (PMS).
• Create and update contract profiles, including carve-outs, exemptions, and rate changes.
• Track contract end dates and ensure timely updates based on Medicare fee schedules and payer updates.

• Perform chargemaster analysis using 12-month billed charges and reports
• Conduct periodic audits and maintenance of chargemaster data
• Execute code-to-rate analysis for specific CPT codes

• Analyze implant reimbursement and multiple-of-Medicare scenarios based on facility needs
• Extract and compile metrics from payer contracts and PDFs for internal reporting

• Review contract rates in response to operational team queries regarding contractual adjustments not taken
• Manage daily tasks received through the C3PO workflow tool from departments like coding, charges, payment posting, and AR

• Maintain and regularly update the contract loading tracker
• Ensure accurate CPT code loading in the PMS

• Oversee provider credentialing and re-credentialing processes across ASC facilities
• Ensure timely submission and follow-up with payers for credentialing approvals
• Maintain accurate credentialing records and documentation

• Bachelor’s degree in healthcare administration, Business, or related field (master’s preferred).
• 6–10 years of experience in provider credentialing and managed care contracting.
• Strong knowledge of Medicare and commercial payer reimbursement methodologies.
• Proficiency in Practice Management Systems, Excel, and reporting tools (e.g., ThoughtSpot).
• Excellent analytical, organizational, and communication skills.

• Experience with ASC operations and revenue cycle workflows
• Familiarity with CPT/HCPCS coding, chargemaster structures, and payer contract terms
• Ability to manage multiple priorities and meet deadlines in a dynamic environment

• Location: Hyderabad
• Department: Managed Care Contracting
• Reports To: Senior Vice President
• Employment Type: Full-Time
• Shift timings: 6PM to 3AM IST (night shift)