Associate Contract Specialist

4 weeks ago

Wheeling, United States West Virginia Employer Full time

West Virginia Employer

Associate Contract Specialist

Wheeling ,

West Virginia

Apply Now

Performs duties to support provider contracting initiatives in accordance with Corporates, Federal and State guidelines. Maintain and enhances the provider network to meet or exceed access quality and financial goals. Ensure contacts are sent and executes timely, loaded correctly for claims payment and contract documents are filed appropriately. Required: * Four (4) year college degree in healthcare admin, business admin, or related field OR two (2) years managed care industry experience. * Knowledge of provider contracting, provider customer service, standard credentialing procedures. * Experience in health care or insurance environment. * Must be able to apply corporates policies and procedures to solve practical problems and deal with a variety or variables in situations where only limited standardization exists. * Good written and oral communication skills. * Ability to interpret and compose spreadsheets, reports and presentations using the Microsoft Office Suite. * Strong analytical, problem solving and project management skills. * Must be able to meet deadlines and work under pressure. * Must be able to work as part of a team or independently. Desired: * One (1) year contracting experience in a healthcare and/or managed care environment. * Experience with current managed care, State, and/or Federal healthcare programs (Medicare, Medicaid) and the insurance industry. * Experience with commercial provider data management and contract management software. Responsibilities: * Prepares, sends, and receives provider documents, including contracts, amendments, addendums and correspondence to grow and maintain the Medicaid, CHIP, Medicare Advantage and Commercial provider networks across multiple markets. * Communicates with providers to obtain documents needed to complete the contracting process. * Responds to phone and email inquiries from providers regarding contract status. * Interact directly with contracting directors and managers to understand what is negotiated and ensure accurate and timely loading of contracts. * Retains executed contract documents and provider correspondence in an electronic contracts management system. * Assist with negotiating single-case agreements (SCAs) with non-participating providers. * Meet departmental productivity standards. * Assures compliance with corporate policies and procedures.

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