Associate Provider Contract Specialist
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Work Shift: Day (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary Range: $21.50 - $34.50 Union Position: No Department Details
Summary
Works in cooperation with the Provider Contract Specialists and other department and organizational colleagues to deliver superior service to the health plans comprehensive network of affiliated health care providers.
Job Description
This individual is responsible to assist in the provider affiliation and contracting activities for hospital, professional, vendor, care system and/or ancillary providers including: coordination of the provider affiliation and termination process, provider outreach for contractual and regulatory requirements, contract document and timeline management, as well as accreditation initiatives. Coordinates the provider affiliation process and incorporates into an affiliation recommendation in alignment with affiliation standards. Assists in management of the provider termination process, including reporting and internal communications. Partners with Provider Contract Specialist(s) to prepare standard provider contract documents, then tracks provider contracts and amendments from initial draft to full execution. Uploads and catalogs all executed contracts in the contract management database. Coordinates meetings with Business Configuration and Provider Contract Specialists for contract implementation and is present to document implementation plans. Collaborates with credentialing and business configuration staff to implement negotiated contracts and ensure accurate information is entered into the credentialing and payment software. Develops and maintains a contract inventory tool to ensure contract deadlines and requirements are satisfied. Develops and maintains a standard provider reimbursement documentation structure. Conducts initial and follow-up outreach to providers for standard delegated credentialing amendment contracting.
Qualifications
Associate degree or 60+ credits in health care, business, marketing, education, or related field, required. Bachelor's degree in business administration, accounting, health care, finance, or related field, preferred. Two years’ experience in a medical group practice or health insurance/Health Maintenance Organization (HMO) environment. Experience with data entry, customer service, claims processing, billing, provider relations, credentialing or contracting. Demonstrated proficiency with the Microsoft Office suite, especially Microsoft Excel. Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to [email protected].