Contracting Specialist

NORTHSHORE HEALTH CENTERS • Portage, IN

2d • Onsite

About The Position

The Contracting Specialist will be a member of the NorthShore Health Centers team and will be responsible for timely processing and completion of initial/re-credentialing insurance contracts for all NorthShore providers and locations. This role involves completing provider applications, maintaining payer compliance, utilizing various online portals, constructing and updating CAQH profiles, enrolling new locations, and communicating contract status with relevant staff. The position operates in an office environment with frequent interaction with patients, physicians, and other healthcare personnel, which can be stressful at times.

Requirements

• Bachelor’s Degree in Healthcare Administration, Business, or related studies
• Ability to analyze situations and solve problems at strategic and tactical levels
• Excellent interpersonal and customer service skills
• Ability to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, ordinances, and policies
• Ability to acquire a thorough understanding of the organization's hierarchy, jobs, qualifications, compensation practices, and the administrative practices related to those factors
• Practiced at organization and planning
• Employ Critical thinking and problem solving
• Maintains composure and operates with emotional intelligence
• Ethical reasoning and decision-making
• Strong attention to detail
• Receptive and responsive to feedback
• Excellent verbal and written communication skills
• Time management, prioritization, and sense of urgency
• Proficient with Microsoft Office Suite or related software

Nice To Haves

• Master’s Degree in Healthcare Administration, Business, or related studies
• Two years of experience working within a healthcare setting

Responsibilities

• Complete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.
• Maintain and remain in compliance with payer and product directory updates monthly and quarterly through portals such as Availity, LexisNexis, Better Doctor, and other validation tools.
• Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and NorthShore locations as they are needed.
• Construct new provider CAQH profiles, update current CAQH applications, and attest the CAQH profiles quarterly for all providers.
• Create new NorthShore location NPIs and enroll the new locations in Medicare, Medicaid, managed care plans, and commercial insurances.
• Communicate with the appropriate NorthShore staff on the status of insurance contracts as needed.
• Performs other duties as identified or assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level