100% Remote Healthcare CSR/ Call Center

Job Summary:

The Contracting Operations team ensures members have adequate and affordable access to the healthcare services they need, even if that means going out-of-network (OON). We execute Single Case Agreements (SCAs) on an ad-hoc basis so that members can receive out-of-network care at an in-network cost.

As a Contracting Representative, you will help ensure that Single Case Agreement (SCA) contracts are executed quickly and carefully. You will compile information and price contracts for our members to receive care from out-of-network providers, by sourcing providers, reaching out to negotiate rates, work cross-functionally across multiple departments to problem-solve barriers, obtain leadership approval, and follow up to get these contracts signed, then inputting terms of the signed contract to our claims team so that providers are paid properly.

You will report into the Associate Operations Manager, Out-of-Network Contracting.

Primary Duties and Responsibilities

• Develop a comprehensive understanding of the contract drafting and execution processes

• Contribute to the reduction of the daily SCA Contracting inventory

• Become an in-house expert on SCA contracting processes

  • Triaging

  • Sourcing

  • Pricing

  • Negotiating cost

  • Drafting

  • Obtaining approval

  • Obtaining signatures

  • Close out

  • Documentation

• Ensure that all SCA contracts are turned around within required timelines

• Escalate issues to various stakeholders and/or leadership to ensure timely resolution

• Support the SCA team by identifying issues and presenting resolutions

• Take ownership of monitoring, tracking, and checking status of the health of all work in progress

• Form relationships with all collaborators

• Contribute to team-wide goals to improve the Contracting team outcomes

Required education and experience

• Associate's degree in Business, Finance, Health Care Administration or at least 2 years equivalent work experience in a related field

• Experience in critical and analytical thinking skills

• Excellent communication skills, both written and verbal

Preferred education and experience

• Bachelor’s degree

• Experience negotiating contracts, specifically with ancillaries, facilities, specialty providers, and physician groups

• Healthcare experience

• Working knowledge of Google Suite software

• Jira workflow exposure

About Medix?

Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.

Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for. Let Medix be your partner as you move your career forward. Contact us today!

Benefits

Once you have been a contract employee of Medix for 30 days, you become eligible for our Benefits Program. Should you elect to enroll, there are three levels of medical coverage to choose from, supplemental dental plans and term plans as well as the option to enroll your spouse and/or children. You can select the best combination that best suits your needs.

As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:

• Minimum Essential Coverage (MEC) plan

• Two different fixed indemnity plan add-ons

• Major Medical Plans, including 1 HSA Plan

• Dental

• Vision

• Short-term disability

• Life and AD&D