Contracts Coordinator

Regal Medical Group•Los Angeles, CA

6d•$23 - $25

About The Position

The Contracts Coordinator is responsible for working as the internal liaison in maintaining, processing and reviewing department databases and reporting on a daily basis to assist the Contracting Department in meeting the overall network growth and development goals. As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Requirements

Minimum of 2 years relevant work experience in Network Management or Contracting in a managed care setting, health plan or large medical group administration.
Knowledge of contracting principles and tools.
Excellent verbal and written communication skills.
Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access and Power Point)
Daily production will vary from day to day. Must be able to multi-task effectively, manage multiple priorities and meet required deadlines.
Ability to work in a fast-paced environment where priorities change on a day to day basis.
Strong time management and organizational skills required.

Responsibilities

Assist in Network growth and development to include preparation of contract packets for recruitment projects.
Under the supervision of the Contracts Manager, responsible to work with Network Managers and providers to obtain proper signatures and documentation to effectively process newly recruited or existing providers.
Maintaining and updating the appropriate databases and department tools with statuses.
Coordinate receipt and processing of all provider contracts, credentialing, and correspondence.
Responsible for timely and accurate completion of PACFs related to incoming documentation received from providers regarding changes to their demographic information in the credentialing and provider network databases.
Responsible for initial review of all credentialing applications prior to submittal to RMG Contracts for completion and accuracy.
Working collaboratively with Director of Contracting, Contracts Manager, Network Managers and other Network Management staff during the contracting process to ensure department goals and requirements are being met.
Responsible for the initial submittal of provider profiles to the Health Plans and follow-up (as requested) to ensure PCPs and Specialists are active in databases.
Daily interaction with regional providers.
Ensure contract compliance and adherence to DMHC, DHS, CMS and other regulatory agencies as required by contracting HMOs.
Interface with internal departments such as Database Management, Claims, Customer Service and Medical Management.
Assist in research of provider-related issues including demographic information, contracting status, credentialing status, claim issues and status in Regal’s various databases.
Respond timely to phone calls and e-mails.
Know and follow the Employee Handbook policies and procedures.
Maintain patient confidentiality so that HIPPAA compliance is observed at all times.
Assist in Special Projects.
Other duties may be assigned as needed.