Program Coordinator & Contract Specialist Plano, TX

Program Coordinator & Contract Specialist

Full Time • Plano, TX
Job Summary 

The Contract Specialist supports operations and owns contracting for the Network Operations – working in conjunction with the Revenue Cycle Management Team. The role’s primary functions include: network onboarding, provider opt in and contracting, network record management, payer relations and operational support. 

Role and Responsibilities 

  • Coordinates and owns the new provider onboarding process to ensure timely activation to payer contracts 
  • Manages network provider rosters to ensure accurate, timely data is provided to payers per network contract requirements 
  • Monitors network attribution per provider to ensure network members are accurately included in payer contracts 
  • Maintains accurate network records on a routine basis in CRM tool 
  • Facilitates and ensures resolution of network provider issues related to payers including but not limited to contracting, network status, billing and claims, and attribution 
  • Manages and maintains network members records and documentation, as it relates to payer contracts, onboarding documents, etc. to include conducting meetings with members of the network 
  • Collaborates with Performance Advocates team to provide an excellent membership experience for network participants 
  • Supports Performance Advocates team with operational items such as reporting, communication, and coordination with accounting department 
  • Performs ad hoc and root-cause analysis as directed by management 
Qualifications and Requirements 

  • Associates Degree or equivalent work experience (Bachelor’s degree a plus) 
  • 1+ years’ experience in a physician’s office or 3+ years related experience in health care environment serving in a credentialing role 
  • Strong communication skills, both written and verbal 
  • Basic Microsoft Office applications experience 
  • Value people; demonstrate professional respect and innovative mindset 
  • Team focus – working in a collaborative environment 
  • Confident in working with health care professionals and insurance payers 
  • Passionate about your work and move forward with purpose 
  • Ability to problem solve when the answer is not clear 
  • Ability to present issues to providers/clients with proposed solutions 
Preferred Skills 

  • Computer literate and Microsoft Office applications proficiency 
  • eCW platform experience 
  • Medical Terminology 
  • Insurance carrier knowledge 
  • Large scale project management experience

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