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    PNO Contract Coordinator - Los Angeles, United States - MedPOINT Management

    MedPOINT Management
    MedPOINT Management Los Angeles, United States

    2 weeks ago

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    Description


    Job Description Job Description SummaryUnder the general direction of the Provider Network Operations (PNO) Contracting Supervisor, the PNO Contract Coordinator is responsible for the managing and supporting the administrative and operational aspects of the PNO Contracting Team.

    This includes but is not limited to pre and post negotiation management, interfacing with PNO, Claims, Utilization Management (UM) and other departments.

    The PNO Contract Coordinator performs basic administrative, clerical, operational, customer support and computational tasks to support the PNO Contract Specialist(s) in the network development component of MedPOINT Managements (MPM) service portfolio.

    Duties and Responsibilities Ensure completeness and conduct follow-ups for receipt of provider applications and supporting documents following providers/vendors contract execution Ensure completeness of health plan required attestations among Clients provider network Log provider follow-up outcomes and status updates in Letter of Agreement (LOA) Utility; submit to the database to be loaded once signed copy is returned Perform continued follow-up on all LOAs, both Patient-Specific and Blanket Complete MPM Contract Routing Checklist upon return to ensure accuracy and completeness of required documents and submit to respective Provider Network Operations database team Assist Contract Specialists and Contracts Supervisor in responding to Health Plan, IPA, DMHC, DHCS, CMS or regulatory body audit requests Respond to and close out MPM departmental requests (Claims, Rates, UM etc.)

    for copies of contracts or amendments Escalate contract inquiries to Contract Specialist if entity/provider requests rate re-negotiation or amendment; log and track all rate re-negotiation requests Upload contracts, amendments, Blanket/Patient-Specific LOAs into respective database/storage repository (EZ-CAP Document Management, Laserfiche, Shared Network Folders, LOA Utility) Participate in weekly B-Report meetings to report on pre-arrivals, communications between hospital LOAs, and pertinent updates Assist in research of provider-related issues including demographic information, contracting status, credentialing status, claim issues and status in MPM database Assist in constant analysis of contracting needs, maintaining spreadsheets and collect, track, prepare, compile, and distribute statistical data for daily and monthly reports Respond to email correspondence and other communication in a professional and timely manner Ensure HIPAA compliance is always observed/performed Understand and follow the MPM Employee Handbook policies and procedures Perform additional duties/assignments as neededMinimum Job Requirements Bachelors degree in healthcare, human services or related field preferred 2+ years Managed Care or Healthcare experience in Network Management or Contracting Knowledge of contracting principles and tools, experience in legal/paralegal process a plus EZ-CAP knowledge preferred Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) Substantive knowledge of the HMO marketplace including Medi-Cal, Commercial, and Medicare#J-18808-Ljbffr
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