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Operations Coordinator I - TEMP

Remote:

Full Remote

Contract:

Freelance

Salary:

4 - 4K yearly

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

High school diploma or equivalent, 2-5 years of preferred experience, Previous coordinator experience required, Proficient in Excel and Word.

Key responsabilities:

Review and save health plan documents
Ensure timely handling of alerts and documentation

Prospect Medical Systems SME https://prospectmedicalsystems.com/

501 - 1000 Employees

See more Prospect Medical Systems offers

Job description

Job Description

The Provider Contracting Operations Coordinator I position performs contracting and operations activities according to Prospect Medical Policies, contracted health plan policies, CMS, DMHC, and NCQA accreditation guidelines

Responsibilities

Review health plan attestations for completeness. Save documents in correct locations with correct naming conventions.
Assess completeness of information on eApply Provider Intake Forms, CPPA and CAQH credentialing applications.
Route initial recruit and new eApply log in alerts to credentialing for Specialist Providers.
Route alerts for Practice Address, Mailing Address and Payment Address changes for Primary Care Providers, Specialists, Hospital Based, Open Ended MOU and Tertiary contracts. Ensure correct documentation has been provided by the requesting party. Upload and save documentation in the correct locations with the correct naming convention.
Route Provider Add alerts for Primary Care Providers, Specialists, Open Ended MOU and hospital based providers. Draft welcome letters for all new Provider Adds. Update Exhibits for all provider adds. Ensure this documentation is uploaded and saved in the correct location with the correct naming convention for all provider add alerts.
Ensure alerts are being worked that are assigned to you. Working them in a timely manner. Escalating alerts if returned over 2 times to manager or audit/training team.
Create shell records for contracts and groups for Letters of Interest. Assign tracking alerts to Regional Managers. Draft and send all LOI denial letters. Archive records and save needed documentation.
Create shell records for practitioners accurately with minimal errors that would create hard exceptions or defects.
Monitor and maintain CONFAX inbox and ProCon Support alert queue.
Note pertinent information for other departments in all alerts. Alerts sent to Provider Configuration and PIM should have the required information for the departments to process the alerts without returning to ProCon Ops.
Other duties as assigned by Management.

Qualifications

Minimum Education: High school diploma or equivalent.
Minimum Experience: Two to five (2-5) years of experience preferred. Previous coordinator experience with IPA / Medical Group / Hospital experience required. Must be proficient in Excel and Word skills. Req.
Certification/Licensure: None .

"Location-Based Pay Adjustment"

About Us

With approximately 9,000 physicians to serve our 260,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Texas and Rhode Island. Our extensive care services range from primary care and specialty physician services to acute care hospital and skilled nursing facilities to behavioral health and wellness services. Each of our Independent Physician Associations (IPAs) and networks support the use of advanced diagnostic and treatment tools to provide our members with convenient access to state-of-the-art healthcare. For 25+ years, Prospect Medical has been focused on our mission of supporting independent physicians where, through risk arrangements, we work closely together with health plans, facilities and healthcare physicians for the benefit of every person who comes to us for care. We provide quality healthcare services that are designed to offer our patients highly coordinated, personalized care and that help them live healthier lives. Prospect Medical Systems manages highly successful IPAs by leveraging our best-practices, results-driven administrative services to manage patients under risk arrangements with health plans/CMS.