Prospect Medical Systems · 2 days ago

Operations Coordinator I

Orange, CA

Full-time

Onsite

Entry Level

1+ years exp

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Hospitals and Health Care

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Responsibilities

Monitor and audit contract applications such as CONFAX, CDA and STRIA to ensure that the documentation is correctly and appropriately processed and stored.

Mails letters, Contracts, MOU's or Amendments to provider. Upon mailing of letters and/or documentation tracks delivery of certified mail.

Logs Letters of Interest (LOIs) in CDA and forwards per department policy.

Creates, maintains and updates CDA and contract summaries with current, accurate contract and demographic information. Maintains contract filing protocol and ensures proper filing.

Supports Queue Coordinator when needed to review and respond to all requests received in the Provider Contracting/Medical Management request Queue (PCON).

Reviews and responds to Provider Contracting inquiries and Claims Queue (5000 Queue).

Supports contracting department by drafting contracts, MOUs, Amendments, and letters

Generates and tracks mass amendment projects by creating merged documents, mailing documents, tracking documents from mailing to receipt.

Receives and/or routes calls to facilitate and resolve customer service of other contracting related issues.

Completes special projects and performs other duties as needed and as assigned.

Qualification

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Healthcare experienceContracting knowledgeCredentialing knowledge

Required

High School Diploma

One (1) year of healthcare related experience

Knowledge of contracting and credentialing functions

Company

Prospect Medical Systems

With approximately 9,000 physicians to serve our 660,000 members, Prospect Medical Systems is proud to be among the most innovative medical systems in California, Arizona, Texas, and Rhode Island.

Orange , CA

501-1,000 employees