Contracting Specialist

California, CA - USA

Hourly Salary: $ 25 - 32

Posted on: Yesterday

Vacancies: 1 Vacancy

Job Summary

Job Title: Contracting Specialist
Department: Provider Contracting

About the Role:
Astrana Health is looking for a Contracting Specialist. This role will report to our Director - Provider Contracting Operations and enable us to continue to scale in the healthcare industry.

What Youll Do

Supports contracting efforts and loading for provider contracts
Negotiate Patient Specific MOUs
Process Load and maintain contracts and providers in contracting database application
Acts as liaison with various internal departments to facilitate and resolve claims provider configuration customer service credentialing and other related issues.
Negotiate and draft LOA/MOU agreements outlining contractual terms as directed
Draft provider terminations and other provider correspondences
Initiate changes to internal departments for updates health plan submissions and member outreach as needed
Load agreements and providers to contracting data application with all contractual terms and linkages
Manage Inquiries email box and Referral Queue
Provide clarification on contractual arrangements to internal departments providers and billing companies
Provides customer service to network providers and other internal departments by responding to contracting inquiries claims questions and credentialing inquiries and provider configuration
Problem solve inquiries regarding contract or provider set up
Works with credentialing department as needed to obtain credentialing and re-credentialing documents
Track and document tasks to completion
Generate reports as requested
Other duties as assigned

Qualifications

Proven ability to prioritize and organize while ensuring attention to detail
Work independently to ensure established turn around times and project deadlines are met
Proficient in Microsoft Office Suite
Working knowledge of DOFRs Claims Utilization Management Network Management Eligibility CPT Coding Diagnosis Coding and Medical Terminology
Strong communication critical thinking problem resolution and interpersonal skills
Ability to read comprehend and interpret managed care contractual agreements

Required Education/Experience:

Three years contract negotiations in a managed care environment working with Medicare and Medicaid fee schedules
Maintain confidentiality and adhere to all regulatory requirements as well as to policies and procedures
Associates degree or equivalent education and experience

Youre great for the role if:

You have knowledge of Commercial Medicare Medicaid lines of business

Environmental Job Requirements and Working Conditions

This is a remote position. The home office is located at 600 City Parkway West 10th Floor Orange CA 92868.
This position requires coming into office at least once per month at our offices located in 1600 Corporate Center Dr. Monterey Park CA 91754 and 600 City Parkway West 10th Floor Orange CA 92868. Additional in-office days may be required based on business needs or special projects.
The total compensation target pay range for this role is $25.71 - $32.99 per hour. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.

Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided on the basis of qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.

Additional Information:

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Required Experience:

Job Title: Contracting SpecialistDepartment: Provider ContractingAbout the Role:Astrana Health is looking for a Contracting Specialist. This role will report to our Director - Provider Contracting Operations and enable us to continue to scale in the healthcare industry. What Youll Do Sup...