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Job Title: Ancillary Contractor,Mngd Care

Company: NorthEast Provider Solutions Inc.

City/State: Valhalla, NY

Category: Clerical/Administrative Support

Department: Managed Care-WMC Health

Position: Full Time

Hours: 5 days per wk-40 hours

Shift: Day

Req #: 24842

Job Details:

Job Summary:

The Ancillary Contractor will assist in contracting for new rates and language for physician groups and ancillary facilities. The incumbent may also assist with hospital agreements with various managed care organizations, including completion of single case agreements.

Responsibilities:

Reviews Agreements, amendments, rate addendums for completeness and appropriate approval and signatures. Ensures credentialing information is complete based on the requirements of the specific provider type. Obtains most current insurance certificates on behalf of the network. Works with internal departments to resolve issues concerning contract language interpretation and rate information. Researches and resolves routine provider operational issues with managed care payers. Schedules Joint Operation Committee (JOC) meetings with Managed Care Payers and key departmental heads within the network. Updates various rate grids with most current rates. Reviews and provides recommendations on single case agreements. Assists with settlements with both participating and non-participating managed care payers. Performs other duties as assigned. Qualifications/Requirements:

Experience:

Five to seven years work experience in related managed care field

Education:

Associates degree or equivalent experience required.

About Us:

NorthEast Provider Solutions Inc.