Business Professional - Contract Specialist I
Company: Saviance Technologies
Posted on: September 24, 2022
Job Description: Position will start as fully on-site at 3000
Corporate Exchange, Columbus, Ohio for the first 90 days and is
expected to transition home once the person passes their 90 days.
Therefore, candidates MUST be local to Columbus, OH.
Schedule requirements will be M-F, 8am-5pm EST.
Candidates will be required to provide their own equipment and have
access to reliable internet after the 90 days training period.
During training, equipment will be provided onsite.
Candidates will be supporting the Georgia Health Plan.
Candidates MUST have provider contracting experience and phone
Summary: 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 publish reports according to
departmental procedures. Essential Functions: 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 state to including
researching, recruiting and negotiating with providers.
Participates in the evaluation of provider network and
implementation of strategic plans to meet ***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. Travels regularly throughout designated
regions to meet targeted needs.
Knowledge/Skills/Abilities: Knowledge in Excel, Word, Outlook, and
PowerPoint programs Ability to interact well with all internal and
external customers Ability to work and make decisions independently
Excellent organizational and verbal and written communication
skills Ability to abide by ***s policies Ability to maintain
attendance to support required quality and quantity of work
Maintain confidentiality and comply with Health Insurance
Portability and Accountability Act (HIPAA) Ability to establish and
maintain positive and effective work relationships with coworkers,
clients, members, providers and customers
Required Education: Bachelors Degree or equivalent work experience
in health care field including, but not limited to, providers
office, managed care, or other health care field. Required
Experience: 0-2 years provider contract negotiation experience in
the health care field including, but not limited to, providers
office, managed care organization, or other health care field.
Comments for Suppliers:
Keywords: Saviance Technologies, Columbus , Business Professional - Contract Specialist I, Other , Columbus, Ohio
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