Terms of Employment
- Contract, 9 Months
- This position is hybrid. Resource must periodically go into the office (less than once per month) to facilitate a mailing campaign and attend onsite team meeting.
- The office is located in Baltimore, MD or Columbia, MD.
Overview
Our client is seeking two (2) Provider Networking Contracting Representatives to join their team. The Provider Networking Contracting Representatives will provide administrative and coordinative support for provider contracting and initiatives. This role will manage escalated and complex inquiries from network providers and care partners regarding Medicare, Medicaid, Commercial and DSNP contracts. The Representative will collaborate with functional teams to deliver timely and professional responses to all inquiries. This role requires a proactive and results-oriented individual with a strong understanding of healthcare reimbursement methodologies and the ability to build rapport with healthcare providers.
Responsibilities include:
- Manage contracting email boxes.
- Works with the appropriate leader to triage and respond to complex and escalated inquiries from external provider practices or health care entities, as well as internal requests and bring to resolution in a timely manner, or escalate to an accountable party.
- Follows up to ensure resolution and/or assists with tasks to support resolution.
- Supporting and organizing contracting related workflows including but not limited to: Carrying out ad hoc mailings, uploading and printing of contracts, updating fee disclosures, editing/updating templates, gathering documentation for audits or other regulatory requirements, researching returned mail and triaging complaints/inquiries.
- Update and maintain supporting documentation, process and standard operating procedures for the department.
- Managing and maintaining provider contracts within an in-house Contract Management System.
- Serve as a point of contact for contracted providers, building strong relationships and addressing any inquiries or concerns.
- Provides regular updates to management with regard to identified and outstanding issues or trends.
- Maintain in-depth knowledge of insurance plans, product offering and reimbursement models.
- Stays abreast of changes and trends in healthcare.
- Participate in weekly 1:1 meetings to discuss responsibilities, track progress against goals, and develop effective strategies.
- Other duties related to provider contracting and network management as assigned.
Required Skills & Experience:
- High School Diploma or GED
- Minimum of 3 years of experience in contract support, demonstrating a solid understanding of contract terms and the ability to discuss them effectively with providers.
- Proficiency with Microsoft Office 365 to include proficient and successful utilization of Word, Excel, Outlook and teams.
- Proven experience in the healthcare or health insurance industry.
- Demonstrated ability to build and maintain strong professional relationships with external stakeholders, particularly healthcare providers.
- Excellent relationship management and interpersonal skills.
- Ability to work independently, manage multiple priorities, and thrive in a fast-paced environment.
nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.
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