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Provider Contract Specialist II, Remote in Washington State- PS15840

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Provider Network Management
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PS15840 Requisition #

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

 

 

*This is a remote position that must be worked in Washington State.*

 

 

Provider Contract Specialist II:

 

Processes custom/specialized provider contracts including Group agreements and works with internal departments to facilitate new and re- contracting efforts for all networks in a defined health service area.

 

Primary duties may include, but are not limited to:

  • Conducts formal review of Contracts and Credentialing documents.
  • Coordinates the approval and issuance of all approved contracts to the appropriate parties with various internal departments such as credentialing, reimbursement and provider database.
  • Performs basic research to determine the legal names of group, reimbursement method required, as well as the status of the provider group at time of request.
  • Creates boilerplate provider contracts and selects and inserts optional paragraphs/riders as required.
  • Maintains automated tracking system and maintains status logs.
  • Maintains related provider group contract files and sets up group for future contract documents.
  • May research and administer process for provider group data changes and provider group terminations; prepare and mail all new or re-contracting agreements; and create and maintain all provider files and related documentation.

Requirements:

  • High school diploma or equivalent;
  • Minimum 3 years' experience with provider networks, provider relations, provider contracts, plan procedures and policies; or any combination of education and experience, which would provide an equivalent background.
  • Experience or operating knowledge with Facets, Emptoris and/or Contraxx preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com An Equal Opportunity Employer/Disability/Veteran

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