Job description

New Contracts Coordinator

$60,000-$65,000

The New Conracts Coordinator will operate all aspects of the health plan and governmental credentialing processes for new facilities. They will be responsible for Credentialing

Applications, renewals, and private and governmental plans including Medicaid, TriCare, Tribal, and the Veteran’s Administration systems. Additionally, this position will be responsible for the negotiation, implementation, monitoring, and evaluation of new facility managed care payer contractual arrangements. As a part of the RCM Department the New Contracts Coordinator will partner with the Revenue Cycle staff to ensure all system configurations are properly set up and maintained to process claims according to contracts.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Submit applications for new contracts.
• Read provider manuals and annotate important information by creating billing and UR dossiers once contracted
• Coordinate between various departments including legal, development, and the Vice

President of Contracting and Payer Relations to navigate through contracting and credentialing process.

• Facilitate the smooth transition of new contracts to the Contracting and Credentialing Specialists.
• Demonstrate proven knowledge of managed care concepts, industry terms,(re)credentialing lifecycle.
• Develop strong relationships with internal stakeholders, including Facility and Corporate, as well as Payor representatives.
• Confidence and experience handling escalation processes to achieve desired outcomes.
• Proactive nature, intellectual curiosity and proven ability to research unknowns (Payors, Markets; Agencies)
• In-depth knowledge of national and local payors and markets throughout the country.
• Possess strong critical and strategic thinking, ability to follow instructions, with big picture in mind.
• Ensure the appropriate processes are in place to monitor and maintain systematic and timely (re)credentialing efforts with various health plans and facilities throughout the United States.
• Maintain effectiveness when experiencing major changes in work responsibilities or environment; adjust effectively to working within changing priorities, processes, and requirements.
• Knowledge and understanding of provider relations as it relates to all aspects of (re)credentialing.
• Strive to limit the usage of non-participating agreements, by evaluating the utilization of non-pars and the financial ability to ensure revenue is obtained.
• Support other functional areas, including business development, RCM, and UR with reports and data relating to all contracts and credentialing.

SUPERVISORY RESPONSIBILITIES:

• None

COMPETENCIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Intellectual

• Analytical, detailed-oriented, and process-oriented mindset.
• Ability to synthesize large amounts of information.
• Excellent problem-solving and critical thinking skills.

Interpersonal

• Excellent communication skills both verbal and non-verbal.
• Must be able to work with a wide variety of individuals with different backgrounds.
• Ability to accurately communicate expectations to a team.

Leadership

• Self-starter mentality.
• Ability to take lead in gathering and researching materials.

Organization

• Excellent organizational capabilities.
• Ability to maintain clarity on large, complex projects so they can be driven to completion.
• Prioritize tasks properly in a high-intensity environment.

Self-Management

• Ability to self-assess and improve on weaknesses.

Language, Math, and Reasoning

• Excellent communication skills and grammar.
• Ability to write emails and memos in a clear and concise manner.
• Quantitative reasoning to estimate timelines.

EDUCATION, EXPERIENCE, and TRAINING:

• Bachelor’s Degree in Healthcare Administration or health-related field preferred.
• Experience and success(es) in provider (re)credentialing.
• Experience in managing/maintaining current CAQH profiles.
• Strong knowledge of managed care and Medicaid, preferred.

CERTIFICATES, LICENSES, REGISTRATIONS:

• None

COMPUTER SKILLS:

• Proficiency in MS Office, document tracking or similar software in addition to more general office computer systems.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• The employee must occasionally lift and /or move up to 25 pounds.
• While performing the duties of this job, the employee is regularly required to sit; talk; hear.
• While performing the duties of this job, the employee is frequently required to reach with hands and arms.
• While performing the duties of this job, the employee is occasionally required to stand; walk; use hands to finger, handle, or feel.

VISION REQUIREMENTS:

• There are no special vision requirements.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This position works in an environment with moderate noise level. (Examples: business office with computers and printers, light traffic.)

Landmark Recovery 720 Cool Springs Blvd Suite 500 | Franklin, TN 37067 | (855) 766-9527 | LandmarkRecovery.com

Job Type: Full-time

Pay: $60,000.00 - $65,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 5x8
• 8 hour shift
• Day shift
• Evening shift
• On call
• Weekend availability

Ability to commute/relocate:

• Franklin, TN 37067: Reliably commute or planning to relocate before starting work (Required)

Work Location: One location

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