Provider Contract Configuration Specialist

Posted 3 days ago

doctors healthcare plansMiami (FL)

Medical Records Specialists Computer Systems Design Services

SENIORITY

Senior

Apply

About the role

Position Purpose: Configuration and maintenance of provider contracts and benefits

Responsibilities:

Configure and load provider contracts
Maintain provider rosters
Maintain Provider Directory data
Test provider contract and fee-schedules
Review provider data integrity reports
Resolve claims related tickets
Train system users
Meet performance goals as established for the position
Perform additional duties and responsibilities as assigned by management

Qualifications:

Experience in Medicare Advantage Plan, managed care or healthcare environment at large
Experience with provider contract configuration and claims processing
Knowledge of PCP, specialist, hospital and ancillary contracts
Analytical and critical thinking skills
Ability to manage priorities and execute tasks in a high-pressure environment
Computer literacy: MS Excel, MS Word and MS PowerPointBachelor's degree preferred; an equivalent combination of education and experience will be considered

Note: This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member. No Third Party Agencies or Submissions Will Be Accepted. Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP Opportunities posted here do not create any implied or express employment contract between you and our company / our clients and can be changed at our discretion and / or the discretion of our clients. Any and all information may change without notice. We reserve the right to solely determine applicant suitability. By your submission you agree to all terms herein.

Before you apply

Applying takes about a minute. These four things decide how fast it moves after that.

Your profile is current

It's what we read first. Occupations, seniority and locations matter more than a long history.

Two examples you can talk through

Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.

A number in mind

What you're on now and what would make you move. We negotiate better when we know both.

Your notice period

Employers plan around it, and it's the question that stalls offers most often.

Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.