Project Coordinator - Hybrid

Conifer Value Based Care • Los Angeles, CA

122d • $22 - $33

About The Position

Accountable for a wide range of duties in support of client management activities, including but not limited to, research and resolve client operational and provider financial issues (provider disputes, claims and utilization management issues). Accountable for the client membership and enrollment activity, including but not limited to, contract negotiations. Accountable for the client administrative support, such as, answer phone calls, track issues, update calendar, draft board minutes, prepare board packets, and schedule meetings.

Requirements

• 2-4 years of experience in a medical setting, health insurance or related area.
• 2+ years in managed care experience preferred.
• Working knowledge of risk bearing organization and the delegated UM, Credentialing, Network Management, Customer Service, Finance, and Case Management.
• Intermediate MS Office required (Outlook, Excel, Word and PowerPoint).
• Excel Pivot tables and Access skills a plus.

Nice To Haves

• Entry level self-starter and career minded interested in healthcare field.
• Intermediate MS Office required (Outlook, Excel, Word, and PowerPoint).
• Excel Pivot Tables and Access skills a plus.

Responsibilities

• Log and resolve customer service incidents.
• Research provider claims and utilization management issues.
• Investigate and resolve the underlying root cause of repeat provider claim disputes or referral issues.
• Validate provider system set up and configuration.
• Ensure accurate and correct provider fee schedules set up.
• Manage enrollment activity and identify variances in monthly membership reports.
• Track changes at the primary care provider level.
• Develop action plan to address membership changes and work with provider representative to increase membership for the client.
• Identify and resolve provider network adequacy and/or specialty need required for client provider network.
• Provide and track all in-house client issue and resolution support for the Provider Practice teams.
• Negotiate terms for letter of understanding (LOU) agreements, draft, send, and obtain signed LOUs.
• Prepare board, UM, and QM minutes and packets.
• Document and manage customer service incidents and action logs.
• Close out action items, and draft minutes and agendas.
• Provide general office support such as copying, scanning, indexing of provider contracts.

Benefits

• Medical, dental, vision, disability, and life insurance.
• Paid time off (vacation & sick leave) - min of 12 days per year, accrue at a rate of approximately 1.84 hours per 40 hours worked.
• 401k with up to 6% employer match.
• 10 paid holidays per year.
• Health savings accounts, healthcare & dependent flexible spending accounts.
• Employee Assistance program, Employee discount program.
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree