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Provider Contract Jobs in Wisconsin (NOW HIRING)

Apak, Inc.

Assembler/Contract Packaging Worker

Racine, WI

$14 - $17/hr

Company Description Apak,Inc. is a provider of In-house quality custom contract packaging and turnkey fulfillment. With four facilities located in the Chicagoland and greater Kenosha area, #Apak, Inc ...

EDCi

Contracts Manager

Appleton, WI · On-site +1

$86K - $116K/yr

Provide interpretation of contract terms and conditions to management and other business leads * Act as a focal point for internal and external communications on contract matters * Participate in the ...

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Provider Contract information

What is a provider contract?

A provider contract is a formal agreement between a healthcare provider, such as a doctor or hospital, and a health insurance company or managed care organization. This contract outlines the terms under which the provider will deliver medical services to insured members, including reimbursement rates, covered services, and billing procedures. Provider contracts help ensure that patients receive agreed-upon care at predetermined costs and establish the responsibilities of both the provider and the insurer. These agreements are essential for maintaining a network of healthcare professionals who serve plan members.

What is the difference between Provider Contract vs Medical Billing Specialist?

AspectProvider ContractMedical Billing Specialist
CredentialsTypically requires healthcare administration, legal, or business certificationsRequires coding, billing, and healthcare reimbursement certifications
Work EnvironmentHealthcare facilities, insurance companies, or legal officesMedical offices, billing companies, or healthcare providers
Industry UsageUsed in healthcare contracting, negotiations, and legal agreementsUsed in processing insurance claims and patient billing

While Provider Contract specialists focus on creating and managing agreements between healthcare providers and payers, Medical Billing Specialists handle the coding and submission of claims for reimbursement. Both roles are essential in healthcare finance but serve different functions within the revenue cycle.

What are some common challenges faced by professionals in provider contract roles, and how can they be addressed?

Professionals in provider contract roles often encounter challenges such as navigating complex regulatory requirements, ensuring contract compliance, and balancing the interests of both healthcare providers and payers. Additionally, they may need to negotiate terms that are both competitive and sustainable for their organization. These challenges can be addressed by staying up-to-date with industry regulations, developing strong negotiation and communication skills, and fostering collaborative relationships with internal legal, compliance, and finance teams.

What are the key skills and qualifications needed to thrive as a provider contract specialist, and why are they important?

To excel as a Provider Contract Specialist, you need strong analytical abilities, knowledge of healthcare regulations, contract negotiation skills, and typically a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, healthcare reimbursement systems, and proficiency in Microsoft Office are commonly required. Excellent attention to detail, communication, and relationship-building skills help you collaborate effectively with providers and internal stakeholders. These competencies ensure accurate contract execution, regulatory compliance, and mutually beneficial agreements in a complex healthcare environment.
What are the most commonly searched types of Provider jobs in Wisconsin? The most popular types of Provider jobs in Wisconsin are:
Provider Contract jobs near you

Supervisory Contract Specialist

Defense Logistics Agency

Kenosha, WI

Full-time

Posted 8 days ago

Defense Logistics Agency rating

8.3

Company rating: 8.3 out of 10

Based on 35 frontline employees who took The Breakroom Quiz

274th of 842 rated public administrative organizations

Job description

Telework Eligible

Yes

Major Duties

  • Directs all procurement activities which include pre-award, post-award, and contract administration management processes.
  • Develops policies and procedures for work involving the evaluation of contract price proposals, advertising, negotiating, administering, and terminating contracts.
  • Assigns, directs, and reviews for approval the work of subordinate associates.
  • Provides training and guidance to associates with regard to procurement actions.
  • Provides pricing advice on a broad variety of pricing-related issues in developing optimum contracting strategies.
  • Provides pre and post award guidance pertaining to price and cost analyses, negotiation, and settlement support of contractor proposals and contracts.

Qualification Summary

A. Basic Contracting Requirement: A.) A baccalaureate degree from an accredited educational institution authorized to grant baccalaureate degrees OR B.) a current civilian employee in DoD or member of the Armed Forces, who occupied an 1102 position, contracting officer position, or comparable military contracting position with authority to award or administer contracts above the simplified acquisition threshold on or before September 30, 2000 are excluded from the requirements of "A" above. B. Contracting Officer Basic Requirement: Must possess at least 2 years of experience in a contracting position. C. Specialized Experience: One year of specialized experience that equipped you with the particular competencies to successfully perform the duties of the position and is directly in or related to this position. In addition to meeting the Basic Education Requirement above, to qualify for the GS-13 grade level, specialized experience must be at the GS- 12 grade level or equivalent under other pay systems in the Federal service, military or private sector. Applicants must meet eligibility requirements including time-in-grade (General Schedule (GS) positions only), time-after-competitive appointment, minimum qualifications, and any other regulatory requirements by the cut-off/closing date of the announcement. Creditable specialized experience includes: Analyzes difficult contracting issues and identifies alternative courses of action. Solves a variety of contracting problems, including those requiring significant departures from previous approaches. Experience serving as a Contracting Officer with authorization to enter into and administer contracts on behalf of the government through negotiations, bids and competitive proposal procedures with private contractors. Experience reviewing procurement requests to assure clarity, adequacy and completeness. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional, philanthropic, religious, spiritual, community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

What Defense Logistics Agency employees say

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