Credentialing and Contracting Specialist (reputed company!)

Description Job Summary: The Credentialing and Contracting Specialist will be responsible of our Provider Networks through contracted primary care physicians and specialists, key hospitals, ancillary and any other necessary providers to support LA CENTA’s goals including a healthy population, while achieving high quality measures. Job Duties And Responsibilities • reputed company, negotiate and maintain provider contracted networks and execute reputed company that support network needs. • Handle contracting and credentialing needs reputed company provider joins or leaves group • reputed company and maintain strong, cost effective and mutually supportive relationships with key providers and clients. • Maintain internal contract database for management of accurate data and complete contract detail. Ensure timely re-credentialing, reputed company needed. • Coordinate with contract negotiators, performs analysis of contracting needs, including assessment of claims and utilization data to identify areas for new and re-negotiated reputed company. • Advise other departments of new reputed company and amendments, including updating of reputed company internal systems and processes. • Review implementation to ensure contract is appropriately administered. • Ensure timely administration/implementation of contract terms. • Research, analyze and resolve reputed company problems dealing with hospital or provider inquiries • Maintain and manage letters of reputed company from prospective providers • Maintain contract templates and amendments and ensures templates are compliant with State and Federal law, internal operations, products and financial requirements. • Represent department in internal and external audits. • Continually seek out opportunities for functional improvement and improved business processes. • Attend Luncheons or after hour meetings for reputed company reputed company pertaining to contracting. • Handle contracting and credentialing needs reputed company provider joins or leaves group • reputed company other duties as assigned.

Requirements

Qualifications and Experience: To reputed company this job successfully, an individual must be reputed company to reputed company each essential duty satisfactorily. The requirements listed below are reputed company of the knowledge, reputed company, and/or ability required. • Bachelor’s Degree • 2-5 years of extensive experience in contract negotiations • Strong sales and negotiation skills • Advanced knowledge of Insurance types • Excellent oral and written communication skills • Strong relationship building skills to influence and work collaboratively with physicians and other provider leaders Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Individual will be required to: • Sit for long periods at a time. • Stand for long periods at a time. • Use hands and fingers in repetitive motions, daily. • Ability to lift, push, pull up to 20 lbs. periodically. • Travel to clinic locations or sites as needed. • Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Job Type: Full-time Benefits • 401(k) • Dental insurance • Health insurance • Paid time off Schedule • 8 hour shift • Monday to Friday Apply Job!