Contract Specialist: Managed Care Contracting

Hoag • Costa Mesa, CA

2h • $34 - $51

About The Position

The Contract Specialist supports the Managed Care Contracting Department by maintaining the Hoag Network contracting process. The role distributes new and amended PPO, HMO, and ancillary agreements to relevant internal and external stakeholders; maintains and tests Hoag Network contracts in EPIC; and audits contract reimbursement terms, working with payors to resolve reimbursement issues. The specialist also maintains contract files and online contract access and databases, coordinates contract documents for signature across the organization, communicates contract information to internal and external customers, and provides administrative assistance as needed.

Requirements

• High school diploma.
• Three years of experience in an office setting, preferably in health care or managed care.
• Understanding of health insurance plans, including HMO and PPO plans.

Nice To Haves

• Two years of college preferred.

Responsibilities

• Maintain the Hoag Network contracting process for the Managed Care Contracting Department.
• Distribute new and amended PPO, HMO, and ancillary agreements to applicable internal and external stakeholders.
• Maintain and test Hoag Network contracts in EPIC.
• Conduct ongoing audits of contract reimbursement terms and work with payors to address reimbursement issues.
• Maintain contract files, online access to contracts, and related databases.
• Coordinate the flow of contract documents for signature throughout the organization.
• Communicate contract information to internal and external customers.
• Provide administrative assistance as needed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED