100% Remote Healthcare Contract Specialist - Philadelphia, United States - Contemporary Staffing Solutions

Contemporary Staffing Solutions Philadelphia, United States

2 weeks ago

Description

Job Description

Contemporary Staffing Solutions is seeking a dedicated and detail-oriented Provider Operations Specialist to join our client for a remote opportunity In this role, you will play a crucial part in operationalizing both new and existing provider contracts, ensuring accuracy and adherence to contractual terms.

Responsibilities:

Assist in loading and testing provider contracts.
Support setup of new contracts, fee schedules, and amendments.
Coordinate annual contract rate updates.
Handle claims pricing inquiries and coordinate resolutions.
Audit contract loads for adherence.
Review and align provider demographic data with agreements.
Contribute to quality improvement efforts.
Adhere to turnaround time standards.
Understand organizational strategies.
Provide feedback on system needs.
Participate in system testing and improvements.
Perform other assigned duties.

Required Experience / Education:

Associates Degree
Minimum of 1 year of experience
Experience in a managed care/healthcare environment.
Extensive Professional Provider and/or Facility reimbursement experience required.
Experience creating fee schedules.
Understanding of complex provider contracts.
Knowledge of binding terms and provisions in contracts.
Functional knowledge of payment methodology.
Experience with contract loading systems involving interpreting and programming reimbursement methodologies.
Strong analytical and problem-solving skills.
Familiarity with Medicare and Commercial reimbursement methodologies.
Strong verbal and written communication skills.

Company DescriptionContemporary Staffing Solutions (CSS) is a company that exudes unwavering results with urgency, honesty, and integrity. CSS has been a leading provider of contract, temporary, and direct hire solutions. Nationally supporting Salesforce Projects & Managed Services and staffing solutions with a focus in Accounting & Finance, Human Resources, Sales & Marketing, Information Technology, Salesforce, and Call Center & Office. Everyone at CSS operates with pro-active pipelines, the highest business ethics, a winning spirit in our approach, and a team-oriented workflow with real cross-training. The CSS team coaches you with current business intelligence so that we can timely deliver solutions to meet your expectations. Our testimonials on our website tell the story from our clients and candidates—check them out

Company Description

Contemporary Staffing Solutions (CSS) is a company that exudes unwavering results with urgency, honesty, and integrity. CSS has been a leading provider of contract, temporary, and direct hire solutions. Nationally supporting Salesforce Projects & Managed Services and staffing solutions with a focus in Accounting & Finance, Human Resources, Sales & Marketing, Information Technology, Salesforce, and Call Center & Office. Everyone at CSS operates with pro-active pipelines, the highest business ethics, a winning spirit in our approach, and a team-oriented workflow with real cross-training. The CSS team coaches you with current business intelligence so that we can timely deliver solutions to meet your expectations. Our testimonials on our website tell the story from our clients and candidates—check them out

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