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Contracting Specialist

NORTHSHORE HEALTH CENTERS
Posted a day ago, valid for 12 days
Location

Portage, IN, US

Salary

Competitive

Contract type

Full Time

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Sonic Summary

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  • The Contracting Specialist position is located in Portage, IN, and involves processing initial and re-credentialing insurance contracts for NorthShore Health Centers providers.
  • Candidates are required to have a Bachelor's Degree in Healthcare Administration, Business, or related fields, along with two years of experience in a healthcare setting.
  • The role includes maintaining compliance with payer directories, creating and updating provider profiles, and communicating contract statuses with NorthShore staff.
  • Essential skills include problem-solving, excellent interpersonal abilities, and proficiency in Microsoft Office Suite.
  • The salary for this position is not specified in the job description.

Job DetailsJob Location: Portage, IN 46368 Summary/Objective  The Contracting Specialist will be a member of the NorthShore Health Centers team and will be responsible for timely processing and completion of initial/re-credentialing insurance contracts for all NorthShore providers and locations.    Essential Functions  Complete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.  Maintain and remain in compliance with payer and product directory updates monthly and quarterly through portals such as Availity, LexisNexis, Better Doctor, and other validation tools.  Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and NorthShore locations as they are needed.  Construct new provider CAQH profiles, update current CAQH applications, and attest the CAQH profiles quarterly for all providers.  Create new NorthShore location NPIs and enroll the new locations in Medicare, Medicaid, managed care plans, and commercial insurances.  Communicate with the appropriate NorthShore staff on the status of insurance contracts as needed.  Performs other duties as identified or assigned.    *These essential functions are a summary of the primary duties and responsibilities of the position and are not intended to be a comprehensive listing of all duties and responsibilities.  The position will include other duties as assigned, and duties are subject to change at management's discretion.    Competencies  Planning and strategic foresight  Responsible Decision Making  Integrity and accountability  Innovation and creativity  Adaptive and flexible  Leadership, teamwork, and conflict resolution  Professionalism and work ethic  Empathy  Work Environment  Work is performed in an office environment. Involves frequent personal and telephone contact with patients, physicians, and other healthcare personnel. Work may be stressful at times. Interaction with others is constant and interruptive.   Travel  Travel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.    Required Role Qualifications  Bachelor’s Degree in Healthcare Administration, Business, or related studies    Preferred Role Qualifications  Master’s Degree in Healthcare Administration, Business, or related studies  Two years of experience working within a healthcare setting    Required Skills  Ability to analyze situations and solve problems at strategic and tactical levels   Excellent interpersonal and customer service skills  Ability to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, ordinances, and policies  Ability to acquire a thorough understanding of the organization's hierarchy, jobs, qualifications, compensation practices, and the administrative practices related to those factors  Practiced at organization and planning  Employ Critical thinking and problem solving  Maintains composure and operates with emotional intelligence  Ethical reasoning and decision-making  Strong attention to detail  Receptive and responsive to feedback  Excellent verbal and written communication skills  Time management, prioritization, and sense of urgency  Proficient with Microsoft Office Suite or related software    Qualifications




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