We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

Work closely with the Provider Contracting team and support Provider Contracting Department in work flow process as well as act as the liaison with various internal departments to facilitate and resolve claim, system, customer service and other related contracting issues.

Job Responsibilities/Duties

• Monitor and audit contract applications such as CONFAX, CDA and STRIA to ensure that the documentation is correctly and appropriately processed and stored.
• Mails letters, Contracts, MOU's or Amendments to provider. Upon mailing of letters and/or documentation tracks delivery of certified mail.
• Logs Letters of Interest (LOIs) in CDA and forwards per department policy.
• Creates, maintains and updates CDA and contract summaries with current, accurate contract and demographic information. Maintains contract filing protocol and ensures proper filing.
• Supports Queue Coordinator when needed to review and respond to all requests received in the Provider Contracting/Medical Management request Queue (PCON).
• Reviews and responds to Provider Contracting inquiries and Claims Queue (5000 Queue).
• Supports contracting department by drafting contracts, MOUs, Amendments, and letters
• Generates and tracks mass amendment projects by creating merged documents, mailing documents, tracking documents from mailing to receipt.
• Receives and/or routes calls to facilitate and resolve customer service of other contracting related issues.
• Completes special projects and performs other duties as needed and as assigned.

Qualifications

Minimum Education: High School Diploma.

Minimum Experience: One (1) year of healthcare related experience and knowledge of contracting nd credentialing functions.

Req. Certification/Licensure: None.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals, benefit eligible positions will receive:

• Company 401K
• Medical, dental, vision insurance
• Paid time-off
• Life insurance

How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www.eeoc.gov/