Providence Health & Services Commercial Payor Contract Specialist in Burbank, California
Providence St. Joseph Health is calling a Commercial Payor Contract Specialist to our location in Irvine CA, or Burbank, CA.
We are seeking a Contract Specialist to be responsible for understanding, interpreting and solving complex issues arising from Agreements with payers. Intakes managed care operations issues, develops action plans and resolves operational issues within defined time parameters. Responsible for maintaining the accuracy and integrity of the contract documents within contract management system and shared drives.
In this position you will:
Work closely with key stakeholder to resolve operational issues in specified timeframes related to payer and provider contracts.
Show a strong understanding of contract structure and terms. Serves as facilitator for the resolution of complex contract interpretation. Interface with payers on disputes related to contract interpretation.
Utilize strong communication skills, both written and oral required to research, identify root cause by communicating at various levels within the organization, consolidating the issues, and sharing the resolution.
Utilize strong organizations skills required to manage and prioritize work including multiple priorities at the same time. Tracking and communicating current workload and open issues on a regular basis to key stakeholders and leaders.
May participate with negotiators during contract negotiations, on payer issues.
Track issues identified by Revenue Cycle and other stakeholders, where system is unable to be set up correctly to administer language correctly. In collaboration with key stakeholders, develop correction action plan.
Support the annual payer contract renewal, CDM and payer notification process.
Ensure contracts are loaded timely and accurately into both shared drive and Contract Management System.
Responsible for overall contract document maintenance.
Required qualifications for this position include:
Associate's degree in closely related area or equivalent educ/experience.
Payor contracting experience required
2 years of experience with payer billing, collections and reimbursement methodologies and contract language requirements.
Intermediate level working with in Microsoft Suites, including Outlook, Word, Excel.
Preferred qualifications for this position include:
Bachelor's degree in closely related area.
MediTract contract management system experience
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Contracting
Other Location(s): California-Irvine
Req ID: 223133