Responsible for assisting with all day-to-day administrative
and operational activities associated with physician, ancillary and hospital
managed care contracts and PPO networks
DUTIES/FUNCTIONS
Serves
as the department's primary resource for all provider contracts.Duties include processing of all new
contracts, completing the appropriate paperwork for submission of provider
information and compensation changes to Data Management, and maintenance
of all executed contract filling processes.
Responsible
for assisting providers via phone with questions and concerns regarding
claims related issues.In order to
properly address provider issues, consistent interaction with claim
administrators and external clients will be required.
Design
and implement processes to build positive interactions between providers
(physician, hospital, ancillary, etc..) and network contracting team to
appropriately manage issues directly or triage as necessary..
Responsible
for assisting providers via phone with questions and concerns regarding
claims and contract related issues.
Will
assist the provider contracting department with physician recruitment by
forwarding contract documents and working with the physician offices to verify
receipt of documents sent and appropriately triage the physicians to
contract negotiators as needed.
May
also be involved in identifying and remediating operational processes and
researching and remediating claims.
Researches
provider demographic and other detailed information pertaining to
physician data and communicates correction and update needs to Data
Management.
Maintains
confidentiality of information in accordance with company poligy.
Performs
other duties as required.
KNOWDLEGE/SKILLS
Working
knowledge of Microsoft Office products including Excel, MS Word and Access
Knowledge
of medical coding and billing required
Knowledge
of health care environment, preferably in a managed care setting
Proven
organization skills
Strong
analytic and problem solving abilities
Effective
written and verbal communication skills
QUALIFICATIONS/EXPERIENCE
Associate's
degree or equivalent experience required
Minimum
1 year experience in a health care
environment
Minimum
2 year experience in a customer service capacity
CONTRACT MANAGER
CUSTOMER SERVICE
SPECIALIST
POSITION SUMMARY
Responsible for developing and enhancing customer
relationships by responding to customer inquiries and resolving customer
concerns.
DUTIES/FUNCTIONS
Interfaces with customers
(including healthcare providers and patients) via telephone, written
correspondence, fax, web and/or electronic mail to respond to routine
inquiries and resolve concerns.
Investigates, analyzes,
and resolves outstanding issues to achieve customer satisfaction; takes
responsibility for following through and bringing outstanding issues to
closure.
Demonstrates a basic
understanding of all products.
Demonstrates
responsiveness and a sense of urgency when dealing with customers and
health care providers.
Maintains production and
phone quality standard.
Proactively takes
responsibility for own self-development.
Demonstrates
professionalism and presents a positive image of the company when
interacting with customers.
Supports individual and
team goals and initiatives; accepts ownership for individual results.
Performs other duties as
required.
KNOWDLEGE/SKILLS
Able to effectively handle
multiple tasks.
Effective verbal and
written communication skills.
Displays a positive,
confident attitude.
Able to absorb and apply
new and changing information.
Highly self-motivated and
accountable.
Able to manager personal
stress; can remain calm and controlled in stressful, unexpected
situations.
Analytical and problem
solving skills.
Strong listening and
interpersonal skills; skilled at developing and maintaining effective
working relationships
Responds positively to
goal setting and performance management.
