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Contract Administrator

2 months ago

Newtown Square, Pennsylvania, United States Talent Software Services Full time
Job Title: Contract Specialist

The Contract Specialist plays a vital role in building and maintaining positive working relationships between their team, Plan, and other stakeholders. This position ensures that contract data and documents are accurately represented in all plan operating systems, and coordinates the resolution of contract administration issues related to contract loading.

Key Responsibilities:
  • Demonstrates a working knowledge and ability to explain AmeriHealth, Plan regulations, policies, and procedures related to provider contracts.
  • Responsible for auditing contract documents and provider records for completeness and accuracy.
  • Manages and monitors Excel reports for projects and other assignments.
  • Swiftly aligns contract documents to provider records in the operating system with 95% accuracy.
  • Creates contract records in the contract management system with 95% accuracy.
Provider Contract Management:
  • Demonstrates a functional knowledge of managed care provider types, contract types, and reimbursement methodologies.
  • Monitors electronic contract files and ensures Plans are adhering to current policies and procedures for records management.
  • Maintains focus and professionalism in fast-moving and changing environments.
  • Effectively communicates pertinent information to all parties concerned to execute quality services.
  • Escalates requests contrary to established business processes or contract language for resolution.
Administrative Responsibilities:
  • Performs other duties and projects as assigned.
  • Adheres to Plan policies and procedures.
  • Attends required training sessions as needed.

Requirements:

  • 3 years Medicaid experience preferred; 1 year in a Provider Services position.
  • 5 years in the managed care/health insurance industry.
  • Previous experience working with healthcare providers.
  • Previous provider relations experience preferred.
  • Superior systems navigation skills.
  • Excellent knowledge of contract administration and provider record management.
  • Superior ability to work independently and manage projects.
  • Strong assessment and problem-solving skills.
  • Proficient with office software applications.
  • Ability to prioritize and manage multiple tasks simultaneously.
  • Detail-oriented.
  • Excellent verbal and written communication skills.
  • Effective interpersonal, organizational, project management, presentation, and leadership skills.