JOB SUMMARY
The Provider Contract Coordinator – Security Health Plan (SHP) works in cooperation with the Provider Contract Specialists and other department and organization colleagues to deliver superior service to SHP’s comprehensive network of affiliated health care providers. This individual is responsible to assist in the provider affiliation and contracting activities for hospital, professional, vendor, care system and/or ancillary providers including: coordination of the provider affiliation and termination process, provider outreach for contractual and regulatory requirements, contract document and timeline management, as well as accreditation initiatives.
JOB QUALIFICATIONS
EDUCATION
For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.
Minimum Required: Associate degree or 60+ credits in health care, business, marketing, education, or related field.
Preferred/Optional: Bachelor's degree in business administration, accounting, health care, finance, or related field.
EXPERIENCE
Minimum Required: Two years’ experience in a medical group practice or health insurance/Health Maintenance Organization (HMO) environment. Experience with data entry, customer service, claims processing, billing, provider relations, credentialing or contracting. Demonstrated proficiency with the Microsoft Office suite, especially Microsoft Excel.
Preferred/Optional: Experience in payor and/or provider contracting, including professional services, facility, lab, Federally Qualified Health Centers, dental services, and financial analysis.
CERTIFICATIONS/LICENSES
The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.
Minimum Required: None
Preferred/Optional: None
This will be a hybrid position - majority remote with ability to come onsite as needed
Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first.
Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.