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Contracts Clerk
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TEMP - Program Specialist
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Program Specialist
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Orange, United States The Midtown Group Full time $26 - $40Job DescriptionJob DescriptionSalary Grade: $26.91 - $40.36/hrOffer will be made by client based on experience and their internal scale!Monday - Friday; 8am 5pmJob SummaryOne of our most prestigous healthcare clients is seeking a highly motivated an experienced TEMP - Program Specialist to join our team. Under general supervision, the Program Specialist...
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Grievance Resolution Specialist
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Paralegal Specialist
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Financial Grants Specialist
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1 month ago
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Contract Analyst
2 months ago
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Automotive Billing Specialist
6 days ago
Orange, California, United States US Auto Trust LLC Full timeLocation: Orange County, CA At US Auto Trust, we are more than just a dealership; we are a forward-thinking organization that values our employees as our most important asset. We take pride in cultivating a lively workplace culture, offering not only standard benefits such as health, dental, and a 401k plan but also unique perks like monthly appreciation...
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Automotive Billing Specialist
6 days ago
Orange, California, United States US Auto Trust LLC Full timeLocation: Orange County, CA At US Auto Trust, we are more than just a dealership; we are a forward-thinking organization that prioritizes our employees as our most valuable resource. We take pride in cultivating a lively workplace atmosphere, providing not only standard benefits such as health, dental, and a 401k plan but also distinctive perks like monthly...
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Multilingual Client Support Specialist
7 days ago
Orange, California, United States Cogent Infotech Corporation Full timeJob OverviewPosition: Multilingual Client Support SpecialistContract Duration: 6 monthsWork Arrangement: OnsiteRole Summary:The Multilingual Client Support Specialist plays a crucial role in fostering a culture centered around exceptional service and accountability. This position involves:Program Assistance: Engaging in high-quality performance with a focus...
Contract Specialist
2 months ago
Supports contracting efforts in assigned region for owned and MSO business relationships. Negotiate and draft agreements, amendments, Open Ended Memorandum of Understandings (MOUs), and Patient Specific MOUs. Process, Load, and maintain contracts and providers in contracting database application. Acts as liaison with various internal departments to facilitate and resolve claims, provider configuration, customer service, credentialing, and other related issues.
Responsibilities
Negotiate and draft agreements and amendments outlining contractual terms as directed.|Engage in specialty provider recruitment efforts to support network adequacy requirements. Present contracts and amendments for execution. Draft provider terminations and other provider correspondences. Initiate Alerts for adds, terms, and changes to internal departments for claims and referral system updates, health plan submissions, and member outreach as needed.|Load agreements and providers to contracting data application with all contractual terms and linkages.
Manage Claims Inquiries email box and Referral Queue.
Negotiate MOUs as needed for referrals to non-contracted providers and secure savings for non-contracted claims.
Provide clarification on contractual arrangements to internal departments, providers and billing companies.|Provides customer service to network providers and other internal departments by responding to contracting inquiries, claims questions, and credentialing inquiries, and provider configuration. Follow up for return of signed contracts, amendments, credentialing applications, and attestations.|Works with credentialing department as needed to obtain credentialing and re-credentialing documents. Provides administrative support to Contract Administrator and Contract Manager. Generate reports as requested and other duties as assigned Track and document tasks to completion.
Qualifications
Three (3) years contract negotiations in a managed care environment working with Medicare and Medicaid fee schedules required. Knowledgeable of Commercial, Medicare, Medicaid lines of business required.Maintain confidentiality and adhere to all regulatory requirements as well as to policies and procedures.Associates degree or equivalent education and experience
