Contract Specialist PHO

Description

:The Contract Specialist must review and understand provider, workers compensation, managed care and other contracts; utilize standard contracting documents; develop and implement contract ranking/qualifying system; develop and implement contract tracking system; prepare contract summaries, payor notices and updates; contract troubleshooting; research projects. Must be detail-oriented and keep a history of communication and processes as they pertain to the contracting process. Responsible for tracking and ensuring execution, renewal and renegotiation of all applicable contracts, amendments, and addendums. Responsible for facilitating communication between employer groups, third party administrators, and office staff. Assists in development of new documents as appropriate; maintains standard contracting documents in contractual relationships. Assists in maintaining complex spreadsheets of financial and reimbursement data for management. Able to organize, prioritize and multi-task to execute projects and day to day work flow. Proficient in interpreting employer group and other payer benefits. Able to work independently with minimal supervision. Education Required: High School Diploma or Equivalent Preferred: Bachelors in a Related Field Experience Required: 3-5 Years experience working in the healthcare industry, insurance, legal and/or Managed Care industry. Skills Working knowledge of contracts. Experience in contracting, claims processing, filing, or coding in a provider office and/or clinic, legal, or insurance organization Proficient in all Microsoft programs, database experience preferred Ability to communicate effectively with different levels of management Ability to handle difficult situations professionally Ability to make routine decisions in accordance with departmental policies and procedures. Licensure/Certification/Registration N/A