Pragmatic Contract Administrator with extensive data analysis and contract negotiation talents. Organized professional with more than 20 years of experience preparing cost comparisons, service level agreements and non-disclosure agreements.
Overview
22
22
years of professional experience
Work History
Research Budget Contract Administrator
Illinois CancerCare, P.C.
Peoria, IL
2013.04 - Current
Coordinated changes to agreement which might occur during contract lifetime.
Monitored incoming contracts and service agreements for correct pricing and information.
Oversaw full contract administration processes for over.
Provided administrative support for several projects.
Created policies and procedures meeting regulatory guidelines and compliance standards.
Reviewed quotes from contractors to obtain best pricing and service for organization.
Coordinated and attended meetings as company's main contact to review contractual obligations.
Negotiates/manages all budgets and contracts with non-NCORP study sponsors.
Oversees research pricing/subcontracts with local healthcare providers and hospitals, authorizing payment for research-funded tests.
Oversees Medicare compliance for billing tests and services.
Prepares and tracks invoices/payments from study sponsors.
Performs monthly budget review and expenditure analysis.
Coordinates employee reimbursement and employee relations expenses.
Reviews all Financial Conflicts of Interest for Research Department.
Managed Care Coordinator
Methodist Medical Center Of Illinois
Peoria, Illinois
2002.11 - 2013.03
Implemented best practice standards for billing resulting in substantial reduction of accounts receivable delays.
Conducted literature and coding reviews to adhere to state and federal standards.
Tracked expiration dates on documents and communicated with appropriate staff to avoid late filing.
Enrolled providers and Medicaid, Medicare and private insurance plans.
Obtained NPI numbers for providers and facilities and updated existing profiles.
Senior Claims Examiner
Employee Benefits Corporation
Peoria Heights, Illinois
1999.11 - 2002.11
Managed large volume of medical claims on daily basis.
Used administrative guidelines as resource or to answer questions when processing medical claims.
Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
Paid or denied medical claims based upon established claims processing criteria.
Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Examined claims forms and other records to determine insurance coverage.