Contracts Specialist

4 weeks ago

Newtown Square, United States Allere Full time
Job DescriptionJob DescriptionAt ALLERE GROUP, we pride ourselves in creating the perfect match for our candidates. We work tirelessly to build relationships with top companies across the nation, so we always have exciting opportunities for the right candidates. If you are excited about emerging technologies and would love to be a part of a progressive company, we want to talk to youJob Title: Contracts SpecialistLocation: Newtown Square, PA - HybridThe Contract Specialist ensures contract data and documents are represented correctly in all plan operating systems, functions as a pro-active contract administrator and coordinates resolution of contract administration issues relating to loading of contracts: Roles & Responsibilities:
  • Responsible for auditing contract documents and provider records for completeness and accuracy.
  • Responsible for managing and monitoring Excel reports for projects and other assignments.
  • Demonstrates a functional knowledge of managed care provider types, contract types and reimbursement methodologies.
  • Responsible for monitoring electronic contract files and ensuring Plans are adhering to current policies and procedures for records management.
  • Effectively and professionally communicates to all parties concerned the pertinent information required to execute quality services.
  • Responsible for escalating requests contrary to established business processes or contract language for resolution.
  • Supports the Plan, Shared Services, Credentialing, Configuration and Provider Enrollment Services in the investigation of provider data, and credentialing relating to contracts.
  • Researches and communicates results of conflicting data and documents and acts according to policy and procedures.
  • Identifies and reports compliance issues in accordance with Plan policy and procedure.
Required Skills
  • Medicaid experience preferred; 1 year in a Provider Services position.
  • 1+ years in the managed care/health insurance industry
  • Previous experience working with healthcare providers. Previous provider relations experience preferred.
  • Working knowledge of Facets or other claims system is a Plus
  • Knowledge of contract administration.
  • Knowledge of provider record management.
  • Proficient with office software applications (e.g., Excel, Microsoft Office Suite of products)
  • Knowledge of Adobe Suite of Products (Adobe Experience Manager, Digital Asset Management, Work Front)
  • Excellent verbal and written communication skills.
ALLERE GROUP is committed to our community and diversity. We are a proud woman-owned business (WBENC certified) and active supporters of numerous philanthropic, volunteer, and fundraising endeavors. ALLERE GROUP offers direct hire, contract to hire, and statement of work placements. We offer access to employer healthcare benefits, and a 401k retirement plan. Allere Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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