Credentialing and Contract Specialist

Credentialing and Contract Specialist

REMEDIAL PRO LLC

Boca Raton, FL Job Details Full-time 1 day ago Qualifications Contract documentation review Contract review Expiration dates monitoring Provider database maintenance for medical credentialing Healthcare Administration Identifying new business opportunities Provider enrollment for medical credentialing Procurement phase involvement Certified Provider Credentialing Specialist Mid-level Contract management in healthcare 3 years Bidding project phase Proposal writing Compliance documentation Healthcare provider information Insurance provider collaboration Business development within healthcare Project contract management Terms and conditions negotiation Full Job Description The Opportunity Perform all aspects of the credentialing, re-credentialing, and privileging process of applicable medical staff Maintain CAQH, PECOS, and NPI registry for all IHTC providers as applicable. Maintain copies of current state licenses, CSR and DEA certificates, malpractice coverage, and other required credentialing documents. Track license and certification expirations for all providers to ensure timely renewals. Coordinate with the Billing Manager to ensure all applicable providers are correctly attached to all existing and new contracts. Could you make sure provider demographics are kept updated with all payers? Audit health plan directories for current and accurate provider information. Manage the development and implementation of new contracts Participate in the development of new business, acquisitions, and facility expansion. Influence contract strategy in complex contract negotiations and discussions. Lead contract discussions with third-party payers, including rate and language negotiation under established guidelines. Establish and maintain positive working relationships with third-party payer networks. Coordinates the implementation of executed contracts to properly communicate contract requirements/changes internally. Review solicitations and prepare routine responses for proposals, bids, and contract modifications, as necessary. Degree in Healthcare Administration or equivalent experience preferred 3 years of job-related work experience may be accepted in lieu of degree Four years of experience with healthcare provider enrollment and/or credentialing