Contract Specialist PHO

CoxHealth•Remote Missouri, MO

6d•Remote

About The Position

The Contract Specialist reviews and interprets provider, workers’ compensation, managed care, and other contracts, and uses standard contracting documents. The role develops and implements contract ranking and qualification methods and a contract tracking system; prepares contract summaries, payer notices, and updates; troubleshoots contract issues; and conducts research projects. The specialist maintains detailed records of communications and processes related to contracting and tracks contracts, amendments, and addendums to ensure execution, renewal, and renegotiation. The position facilitates communication between employer groups, third-party administrators, and office staff; assists with developing documents and maintaining standard contracting documents; and helps maintain complex spreadsheets of financial and reimbursement data for management. The specialist organizes, prioritizes, and manages multiple projects and daily workflows, interprets employer group and other payer benefits, and works independently with minimal supervision. The role is based at CoxHealth Network in Springfield, Missouri, with a remote Missouri location listed. It is scheduled for 40 hours per week, 8:00 a.m. to 5:00 p.m., on the day shift.

Requirements

High school diploma or equivalent.
Three to five years of experience working in the healthcare, insurance, legal, and/or managed care industry.
Working knowledge of contracts.
Experience in contracting, claims processing, filing, or coding in a provider office and/or clinic, legal, or insurance organization.
Proficiency in Microsoft programs.
Ability to communicate effectively with different levels of management.
Ability to handle difficult situations professionally.
Ability to make routine decisions in accordance with departmental policies and procedures.
Ability to work independently with minimal supervision.

Nice To Haves

Bachelor’s degree in a related field.
Database experience.

Responsibilities

Review and understand provider, workers’ compensation, managed care, and other contracts.
Use standard contracting documents and assist in developing new documents as appropriate.
Develop and implement contract ranking and qualification systems and a contract tracking system.
Prepare contract summaries, payer notices, and updates.
Troubleshoot contract issues and conduct research projects.
Maintain a history of communications and processes related to contracting.
Track and ensure execution, renewal, and renegotiation of applicable contracts, amendments, and addendums.
Facilitate communication between employer groups, third-party administrators, and office staff.
Maintain standard contracting documents used in contractual relationships.
Assist in maintaining complex financial and reimbursement data spreadsheets for management.
Organize, prioritize, and multitask to manage projects and daily workflow.
Interpret employer group and other payer benefits.