Provider Contracting Director jobs in Rialto, CA

JOB SUMMARY
An integral part of the contracting team, the Contracting Database Loader will maintain responsibility for the analysis, modeling, interpretation and loading of healthcare/managed care contractual agreements for Provider, Ancillary, or Specialist in the Payment EzCap database. Duties and responsibilities include but are not limited to:

·         Database management of all contract uploads for Primary, specialty, ancillary or hospital

·         Demographic updates for additions, changes, terminations for existing contracts

·         Intermittent provider loads for UM use.

·         Letters of Agreement (LOA’s) preparation, follow up, uploading.

·         Non-contracted provider loads for incoming claims (Bowman).

·         Network roster maintenance for internal and public use.

·         Network update communications to internal departments & IPA affiliates.

QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform essential function.

Knowledge of:

·         Familiar with EzCap database or similar i.e. Quick Cap.

·         Health plan/vendor contracting.

·         Microsoft office applications (Excel spreadsheets and MS WORD) required.

·         Company policies and procedures.

·         Typing speed minimum 45 wpm.

Ability to:

·         Problem-solve, negotiate, and demonstrate independent decision-making.

·         Prioritize with excellent organizational skills, responding to multiple demands and timeliness.

·         Demonstrate professional written and verbal communication skills and presentation skills using the English language.

·         Demonstrate ability to respond to common inquiries from patients, customers, vendors, regulatory agencies, health plans or members of the business community and possess excellent customer service skills.

·         Twist, turn and utilize reaching motion, ability to sit and/or stand for extended periods of time.

SKILLS
Has knowledge of industry standards and expectations.  Has knowledge of commonly used concepts, practices, and procedures within this field.  Excellent verbal and written skills.  Computer literate with knowledge of EZ-Cap and Microsoft Applications.  Relies on experience and judgment to plan and accomplish goals.  Performs a variety of tasks.  Works independently under the direction of assigned supervisor/manager. Must be able to type at minimum 45 wpm.  Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

EDUCATION and/or EXPERIENCE

High school diploma. Database experience preferred.

LANGUAGE SKILLS

Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or government regulations.  Ability to write reports and/or business correspondence.  Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

PAY: $20/hr – $25/hr DOE

As an Equal opportunity employer, DBA Choice Medical Group is committed to a diverse workforce.  Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin gender, age sexual orientation, physical or mental disability, genetic information or characteristic, gender identity, and expression,  veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws.  In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans’ Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact this post for assistance.

For more information about equal employment opportunity protections, please view the ‘EEO is the Law’ poster.

NOTICE: EMPLOYEE POLYGRAPH PROTECTION ACT
YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT

PAY TRANSPARENCY NONDISCRIMINATION PROVISION

Our environment respects individual differences and recognizes each employee as an integral member of our company. Our workforce reflects these values and celebrates the individuals who make up our growing team.

Choice Medical Group provides a work environment free of harassment and prohibited conduct. We promote and support individual differences and diversity of thoughts and opinion.