Paralegal

Medical Clinic of Houston, L.L.P. • Houston, TX

33d • Onsite

About The Position

This role involves dual responsibilities: coordinating physician and allied health professional credentialing and enrollment activities with various organizations (Medicare, hospitals, health plans, etc.), and performing first-line review for all contracts in support of the Executive Administrator. The credentialing aspect includes preparing and submitting applications, maintaining records, and supporting license renewals, CME tracking, and re-credentialing. The contract review aspect involves maintaining contract terms in a contract management program and coaching managers on negotiation. The role also assists with the implementation and maintenance of a contract management system.

Requirements

• Associate degree in Paralegal Studies or related field required
• ABA-approved paralegal certificate required
• Experience with physician credentialing, Medicare enrollment, and healthcare administration required
• Experience with contract review, management, and negotiation required
• Strong organizational and time management skills
• Strong attention to detail
• Effective written and verbal communication skills
• Ability to maintain confidential and sensitive information
• Ability to coordinate multiple tasks and deadlines simultaneously
• Strong customer service skills when interacting with physicians, management team, and administration
• Professional interpersonal skills with the ability to interact effectively with leadership, physicians, and peers
• Proficiency in Microsoft Office (Word, Excel, Outlook, and PowerPoint)

Nice To Haves

• Bachelor’s degree in Paralegal Studies preferred

Responsibilities

• Prepares and submits initial/on-boarding credentialing and re-credentialing enrollment applications for physicians and allied health professionals with hospitals, health plans, Medicare, and commercial insurance carriers.
• Ensures the Medicare enrollment status for each physician and the entity is complete, accurate, and up-to-date at all times. Responds timely to any and all correspondence received from Medicare.
• Submits new provider information and updates to the National Provider Identifier (NPI) registry and Council for Affordable Quality Healthcare (CAQH).
• Maintains credentialing files for physicians and allied health professionals including licenses, CME, certifications and regulatory documentation. Monitors expiration dates for provider licenses, Drug Enforcement Administration (DEA) registrations, professional liability insurance, and specialty board certifications. Prepares and submits renewal applications and documentation prior to expiration deadlines.
• Maintains complete, accurate, and up-to-date documentation of provider enrollment records with Medicare and managed care entities.
• Assists all department managers/directors by providing first-line review of all contracts in a manner that is consistent with the entity’s standards and Executive Administrator’s expectations. Coaches managers on negotiating tips for requested changes on contracts. Such contracts include, but are not limited to: Employment agreements; Equipment and building maintenance; Equipment and building leases; Bank loans and mortgage loans; Software support services; Contracts with payors and managed care organizations; Supplier contracts; and Service agreements.
• Assists in identifying and handling start-up implementation for a contract management system.
• Maintains all data in contract management system and follows-up as needed on tracking and maintaining finalized, fully executed contracts. Enters all terms and conditions in contract management system including, but not limited to, terms of contract, renewal terms, termination terms and notice periods/process, price escalation agreements, and insurance requirements including current proof of insurance.
• Performs all other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree