Contract Coordinator

Description

Support Provider Services Contracting Department by managing the single case agreements, performing certain administrative functions, writing basic provider contracts, Contract maintenance and other support functions. Reports to the Provider Contracting Program Director.

Qualifications

Minimum Education
Associate’s Degree (Required)
Bachelor’s Degree (Preferred)

Minimum Work Experience
2 years similar level position. (Required) OR 1 year of work experience if being promoted

Required Skills/Knowledge
• At least one year of experience as a customer service representative working with a health plan organization resolving
provider billing and claims inquiries.
• Business software proficiency , including Microsoft Office applications and graphic software.
• Excellent interpersonal, telephone, organizational, and written and verbal communication skills required. Ability to write
business email, letter, or memo in English with no grammar and spelling mistakes and proof assignments to ensure
accuracy of documents.
• Dependable and shows up for work and can apply company policies and business strategies equally to each task and
assignment.
• Delivers on time and follow up on what needs to get done.
• Quickly respond to urgent inquiries the same business day and non-urgent inquiries within twenty four (24) hours or
sooner.
• Enter each encounter in Call Tracking.
• Detail attentiveness required.
• Individual must be self-motivated and willing to self-direct.
• Ability to simultaneously handle multiple assignments and projects with speed and accuracy.

Job Functions
Essential job duties:

• Completes Single Case Agreements (SCA) within three (3) business days of initial complete request from authorized
requestor within Care Management or Utilization Management Department. Tracks SCAs and payments. Converts providers
on SCAs to full contracts in collaboration with the Provider Contracting Program Director.
• Negotiates SCA rates.
• Work with the Utilization Management Reviewers to ensure timely completion of of agreements at terms acceptable to
health plan, generally not to exceed Medicare rates and preferably Medicaid rates.
• Provides out of network providers with requested HSCSN materials for Contracting, Credentialing, and Claims references.
Act as the liaison with out of network providers. Updates out of network providers demographic information in the HSCSN
claims payment system.
• 95% of Agreements have all attached paperwork when ready for signature.
• Maintains log of all SCAs.
• Runs reports quarterly of top volume SCA providers for the previous 12 months.
• Coordinates with Claims and Provider Operations to ensure completion of signed contract checklist.
• 100% of contracts are entered into Contract Management data base within two (2) business days of receipt by Coordinator.
• Contracts filed accurately, in proper folder and order. Coordinate with provider contract configuration analyst team to
assure that all contracts are loaded accurately and in a timely manner and to avoid negative impact on claims, contract
performance due to retro contracts or inaccurate configuration.
• Prepares department reports as needed.
• Completes projects as needed within required timeline.
• Performs with minimal supervision.
• Coordinates completion of projects as assigned within designated timeframe.
• Provide excellent customer service to internal and external customers.
• Maintains all department tracking logs: providers interested in joining the HSCSN Provider Network, provider mailing list,
including email, provider contracts activities to log new and amendments to existing agreements.
• Efficiently writes provider correspondence as needed; copies and faxes documents as requested.
• Always attends mandatory in-services and meetings or makes arrangements with the appropriate supervisor for satisfactory
compliance.
• Completes all job functions as per departmental policies and procedures.
• Maintains current knowledge in present areas of responsibility (i.e. attends ongoing educational programs).
• Demonstrates responsibility for scope of position/own standard of practice.
• For non-clinical areas, has attended training and demonstrates usage of population specific customer service practices.
• Maintains skills, licensure, regulatory requirements, and credentials needed to perform assigned duties.
Other job duties:
May perform other duties in addition to those outlined in this job description.

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