Network Contract Coordinator

Facilitates contract loading and ensures optimal provider service delivery and database accuracy. 

Primary duties may include, but are not limited to: Identifies, analyzes, and resolves problems for multiple provider database issues. Researches and resolves issues for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules. Interprets update requests and coordinates with internal and external customers to clarify and complete the requests. Provides timely research of provider information and creates clear and concise provider database update submissions. Responsible for reviewing incoming contracts and working with the provider relations reps, providers and the credentialing department to facilitate new and re-contracting efforts for Institutional, Professional, HMO and Ancillary products. Researches pended claims, identifies the problems and corrects either internally or via provider education. Reviews professional claims to determine correct reimbursements (pre and post processing) to support network contract agreements. 

Requires a H.S. diploma; 3 years of experience with provider contracts, plan procedures, and policies; or any combination of education and experience, which would provide an equivalent background.