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Job Requirements of Contract Specialist II:
-
Employment Type:
Contractor
-
Location:
Atlanta, GA (Onsite)
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Contract Specialist II
Careers Integrated Resources Inc
Atlanta, GA (Onsite)
Contractor
Job Title: Contract Specialist II
Job Location: Atlanta, GA (Remote)
Job Duration: 12+ Months (with possible extension)
Desired Shift: DAYS – 8HR: 6:45 AM – 3:15 PM, on call.
Job Description:
Qualifications:
Key Responsibilities:
Job Location: Atlanta, GA (Remote)
Job Duration: 12+ Months (with possible extension)
Desired Shift: DAYS – 8HR: 6:45 AM – 3:15 PM, on call.
- MUST LIVE IN GEORGIA.
- Monday to Friday, 8:00 AM to 5:00 PM.
- Potential to be temp to hire.
- Requires 3–5 years of related experience.
Job Description:
- Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases.
- Maintains critical provider information on all claims and provider databases.
- Synchronizes data among multiple claims systems and application of business rules as they apply to each database.
- Validates data to be housed on provider databases and ensures adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing.
Qualifications:
- 3–5 years provider contract negotiation experience in the health care field including, but not limited to, provider's office, managed care organization, or other health care field.
Key Responsibilities:
- Negotiates assigned contracts and letters of agreements with hospitals, physician groups, and ancillary providers that result in high quality, cost effective, and marketable providers.
- Maintains tracking system and publishes reports according to departmental procedures.
- Initiates, negotiates, generates, and tracks provider Letters of Agreement, contracts, and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments.
- Supports network development throughout the state including researching, recruiting, and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Client's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital, and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes.
- Requests information of billing codes, services provided, and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
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