Contract Administrator - Group Health - Hybrid
Location
US-TX-Addison
Job ID
325221
Pos. Category
Corporate - Administration
Pos. Type
Full Time
Overview
Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was provided by Indeed. Concentra's market specific rate/range will be provided during the interview process.
The Group Health Contract Administrator position is primarily responsible for supporting the Group Health Contracting Department and other departments within Concentra such as clinical and billing areas.
Responsibilities
Performs/calculates simple to complex rate analyses
Conducts contract comparisons for language variances
Develops, maintains, and posts all field resource tools such as contract summary/grid documents
Notifies contracted payers of demographic changes including new facility openings, closures, and changes in Doing Business As (DBAs), legal names, Tax Identification Numbers (TINs), remittance addresses, and other demographic information. Follow up with payers to ensure all demographic changes are completed/loaded into the payer systems. Serve as primary payer liaison for these issues
Performs various audits to ensure all field and internal resource tools for group health match to ensure accuracy in reporting and data integrity
Develops and maintain state specific payer lists, including payers accessing facilities through network contracts
Serves as central point of contact for fields and payers for all contract issues other than negotiation/renegotiation
Establishes and maintains payer website access for all internal, field and billing office teams
Establishes and maintains tickler file and notification system of contracts which should be reviewed for potential renegotiation
Submits monthly payer notifications for all facility and provider demographic changes
This job description is not designed to cover or contain a comprehensive listing of activities, duties or
responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Scope measures No direct or indirect reports - No budgetary responsibility
Qualifications
Education/credentials High school diploma or equivalent.
Job-related experience 3 years of experience with contract administration or equivalent in a group health setting.
Job-related skills/competencies Knowledge of contract administration processes in a group health setting.
Ability to accurately type.
Detail oriented and highly organized.
Ability to utilize all proprietary CONCENTRA software programs.
Ability to work independently within guidelines and company policies.
Ability to effectively present information and respond to questions from managers, clients, and customers.
Ability to communicate effectively; must present in a professional, courteous, and tactful manner.
Ability to read and comprehend standardized instructions, short correspondence, and memos.
Ability to effectively present information in one-on-one situations to other employees, providers and clients.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to apply commonsense understanding to carryout instructions furnished in written, oral, or diagram form.
Additional Data
Employee Benefits - 401(k) Retirement Plan with Employer Match
- Medical, Vision, Prescription, Telehealth, & Dental Plans
- Life & Disability Insurance
- Paid Time Off
- Colleague Referral Bonus Program
- Tuition Reimbursement
- Commuter Benefits
- Dependent Care Spending Account
- Employee Discounts
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation, if required.
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management
Concentra is an Equal Opportunity Employer, including disability/veterans