-
The Provider Relations Specialists are to provide FrontPath members with access to a broad provider network. They focus on retaining and growing providers through building relationships. · ...
Perrysburg, OH1 week ago
-
The role of the Provider Relations and Contracting Specialist is to provide FrontPath members and their enrollees with access to a broad and cost-effective provider network. · The Provider Relations and Contracting Specialist coordinates the resolution of provider issues with app ...
Perrysburg, OH1 month ago
-
The primary job function is to prepare capital project contracts with outside vendors for architect/engineer services and construction. · Prepare capital project contracts with outside vendors for architect/engineer services and construction. · Process and track financial require ...
Toledo1 month ago
-
The Contracting and Licensing Specialist plays a vital role in facilitating the contracting process for agents within our organization. · ...
Utah3 weeks ago
-
+The Contracting and Licensing Specialist plays a vital role in facilitating the contracting process for agents within our organization. This position involves interacting with agents, insurance carriers, and internal teams to ensure a seamless onboarding experience. · +Evaluate, ...
Oregon3 weeks ago
- Work in company Remote job
Contracts Specialist, Community Connect, Virtual
Only for registered members
The contract specialist plays a key role in supporting the operations and business development team by coordinating the full lifecycle of contracts related to creating, editing, and maintaining change request contracts for community connect clinics and hospitals. · Cordinating th ...
Oregon1 month ago
-
This is a contracted position as an Intervention Specialist to monitor and report on progress of students in grades pre-k through 12th grade. The role involves demonstrating ABA principles and procedures and leading skill set/project meetings. · ...
Perrysburg, Ohio, , United States1 week ago
-
Halvor Lines offers top pay with real results earning · up to $92k per year. · Strong start with sign-on and orientation pay · The best fleet to drive for winner provides career paths that reward · performance when you succeed we succeed our team members aren't just part · of the ...
Perrysburg Full time1 day ago
-
We are looking for Radiation Therapist (RAD THER) for an immediate opening in Maumee, Ohio.You should have 1-2 years of recent experience in your specialty and a willingness to be flexible and adaptable in new environments. · ...
Maumee3 weeks ago
-
The Special Education Teacher provides quality services to special education students. · Under the direction of the Special Education Program Administrator provides quality services to special education students. · Has a commitment to team participation in planning and implementa ...
Maumee1 week ago
-
The client is seeking an experienced SAP Risk Reporting Specialist to design, build and optimize enterprise risk reporting and analytics across their SAP landscape. · ...
Maumee1 month ago
-
Embark on your journey as a Part-time Fulfillment Specialist, where you'll take charge of delivering excellence by replenishing inventory solutions and managing our industry leading vending program. · ...
Maumee2 weeks ago
-
This role involves delivering excellence by replenishing inventory solutions and managing our industry leading vending program. · ...
Maumee2 weeks ago
-
We deliver a team of professionals that are experts in their specific disciplines yet work in collaboration to coordinate superior outcomes for our clients. · We strive to reduce stress and save time for our clients so that they can focus on what's most important for their famili ...
Maumee $80,000 - $145,000 (USD) per year1 day ago
-
LanceSoft seeks a travel Radiation Therapist in Maumee Ohio for a 13 week assignment with varied shift times. · ...
Maumee1 week ago
-
This position entails the responsibility of prototyping, testing, and documenting processes for all aspects of Research and Development (R&D) and product building. · ...
Maumee1 month ago
-
This position entails the responsibility of prototyping and testing processes for Research and Development (R&D) and product building. · Manage manufacturing assembly process related to up-fitting of vehicles. · Perform a variety of assembly operations using hand tools power tool ...
Maumee1 month ago
-
+This position entails the responsibility of prototyping, testing, and documenting processes for all aspects of Research and Development (R&D) and product building. · +Manage the manufacturing and assembly process related to the up-fitting of vehicles. · Perform a variety of asse ...
Maumee1 month ago
-
Our client is seeking an experienced SAP Risk Reporting Specialist to design, build and optimize enterprise risk reporting and analytics across their SAP landscape. · ...
Maumee, OH1 month ago
-
We are seeking a detail-oriented and proactive Billing & Credentialing Specialist to support the revenue cycle and compliance operations of our Ohio-based behavioral health agency. · This role is essential to ensuring accurate Medicaid and third-party billing, timely reimbursemen ...
Maumee, OH1 month ago
-
Certified Occupational Therapist to join our collaborative team in providing exceptional care to children and adolescents. · ...
Perrysburg, OH4 weeks ago
Provider Relations and Contracting Specialist - Perrysburg - FrontPath Health Coalition
Description
Benefits:
401(k)
401(k) matching
Competitive salary
Dental insurance
Health insurance
Paid time off
Vision insurance
The role of the Provider Relations and Contracting Specialist is to provide FrontPath members and their enrollees with access to a broad and cost-effective provider network. The role focusses on retaining and growing the network providers through building ongoing and trusted working relationships with providers and through delivering excellent provider service. The Provider Relations and Contracting Specialist coordinates the resolution of provider issues with appropriate FrontPath leader or staff.
Major Areas of Responsibility:
• Leads the provider contracting process with new and current participating providers, including standard processes for review of requests for participation, contracting and negotiations for facility, ancillary and professional providers.
· Oversees, conducts and documents facility, ancillary and professional delegated and direct recredentialing cycles. Ongoing monthly review of CAQH Summary reports to identify any listings related to FrontPath providers.
· Maintains an accurate and up-to-date provider database for use in network management, claims repricing and the provider directory. This includes weekly and monthly reporting of provider files to TPAs and weekly updates to the provider directory.
· Assists the FrontPath customer service specialist, and coordinates distribution of problems for resolution to the appropriate FrontPath leader or staff. Conducts personal follow-up with providers, brokers or TPAs on provider related issues and topics.
· Manages the implementation process (provider adds) for all new providers and for implementation of new negotiated facility and ancillary provider rates.
· Coordinates FrontPath resources to respond appropriately to provider inquiries on claims repricing topics and issues.
· Manages communications with providers; provide appropriate educational opportunities and resources; respond to provider claims inquiries, requests for fee schedules and related information.
· Oversees Claimshop user access for members and providers, including loading into ClaimShop and periodic reverification with provider groups and members.
· Negotiates Single Case Agreements with out of network providers or large case agreements with existing tertiary participating providers at the request or with the approval of the plan sponsor.
• Assists in the claims repricing function by processing assigned Pend Codes as required in a timely manner.
· Works collaboratively with internal and external stakeholders to foster strong relationships between FrontPath and network providers to provide value and access to FrontPath members.
• Carries out other duties as assigned.
Experience Required:
• Minimum Bachelor's degree from an accredited college or university or equivalent relevant work experience.
• 3 + years related work experience, primarily including provider contracting or claims oversight functions.
· Demonstrated knowledge relative to local provider and purchaser markets.
· Demonstrated ability and proven track record to create and foster strategic relationships with key stakeholders at provider organizations.
• Demonstrated ability to use analytics to inform rate negotiations and strategic decision-making.
• Excellent oral, written, and interpersonal communication skills.
• Proven ability to work within a team and to foster teamwork.
• Strong planning, problem-solving, time management, organizational and prioritization skills.
· Demonstrated skill in use of Word, Excel, Access, Power Point, Outlook.
This is a full-time position reporting to the President and Chief Executive Officer.
-
Provider Relations and Contracting Specialist
Only for registered members Perrysburg, OH
-
Provider Relations and Contracting Specialist
Only for registered members Perrysburg, OH
-
Senior Contract Specialist - 500436
Only for registered members Toledo
-
Life Insurance Contracting and Licensing Specialist
Only for registered members Utah
-
Life Insurance Contracting and Licensing Specialist
Only for registered members Oregon
-
Contracts Specialist, Community Connect, Virtual
Only for registered members Oregon
-
Intervention Specialists
Only for registered members Perrysburg, Ohio, , United States
-
Reefer Truck Driver - 100 no touch
Full time Halvor Lines- Perrysburg
-
Radiation Therapist
Only for registered members Maumee
-
Virtual Intervention Specialist
Only for registered members Maumee
-
SAP Risk Reporting Specialist
Only for registered members Maumee
-
Fulfillment Specialist
Only for registered members Maumee
-
Fulfillment Specialist
Only for registered members Maumee
-
Practice Manager
Only for registered members Maumee
-
Travel Radiation Therapist - 2,730 per week
LanceSoft- Maumee
-
Engineering Technician
Only for registered members Maumee
-
Assembly Worker
Only for registered members Maumee
-
Engineering Technician
Only for registered members Maumee
-
SAP Risk Reporting Specialist
Only for registered members Maumee, OH
-
Billing Specialist
Only for registered members Maumee, OH
-
Occupational Therapist
Only for registered members Perrysburg, OH