Coordinator Managed Care Contract - Business Office

Job Overview

This role involves overseeing all contract documentation using Tract Manager and other resources to support the ALT program. The coordinator will establish and maintain processes and systems for functional contracting duties to ensure ALT success, providing support to the Executive Director, provider members, and staff.

Key Duties and Responsibilities

• Adhere to Administrative and Department policies demonstrating professionalism in behavior, dress, attitude, attendance, confidentiality, and reliability.
• Act as a resource for the Executive Director, providers, office personnel, hospitals, and facilities involved with ALT.
• Build and maintain productive professional relationships with ALT administration, physicians, staff, hospitals, facilities, and contracted payers.
• Manage processing of new ALT provider packets, including contracts and ballots.
• Send notices and counter-offers to ALT payers as necessary.
• Resolve payer participation and contract-related issues for ALT physicians, staff, hospitals, and facilities.
• Create payer ballots and oversee the balloting procedures for new payer agreements.
• Prepare articles and content for the ALT bi-monthly newsletter.
• Conduct monthly reviews of payer and government websites for policy updates relevant to ALT networks.
• Generate monthly managed care activity reports comparing current to past activity for the Administrative Team and CSMHS Business Office associates.
• Provider Enrollment Responsibilities:
• Assist with enrollment procedures for ALT providers.
• Gather and maintain provider data for payer plan enrollment.
• Prepare and submit enrollment applications and updates to payers, following up on status as needed.
• Coordinate provider approval processes and update ECHO records to inform billing departments to release claims.
• Ensure compliance with payer enrollment standards.
• Maintain provider enrollment details post-approval, including managing CAQH updates, license expirations, Medicare re-attestation, and commercial plan re-credentialing timelines.

Qualifications and Experience

• Minimum educational requirement: High School Diploma or equivalent; Bachelor's degree preferred.
• Experience: 1 to 3 years in provider enrollment or insurance-related functions.
• No specific licenses or certifications required.

Work Schedule

Full-time position requiring 5 days per week at 8 hours per day.