Payor Contract Administrator

Organization is a prominent provider of medical supplies, offering a wide range of urological, ostomy, incontinence, and wound care products. Committed to supporting adaptive sports, we strive to make a positive impact in athletic communities and beyond. Guided by our core values of Adapt, Believe, Compete, we aim to deliver exceptional service despite industry challenges. We prioritize customer care and actively support adaptive sports events and clinics nationwide. With a focus on education and community engagement, we aim to be your trusted resource in the medical supply industry.

Great organization that has a tremendous growth track and is patient focused!

Job Details:
We are seeking a dynamic and detail-oriented individual to join our team as a Permanent Medical Claims Contract Administrator. This role is pivotal in our manufacturing industry setting, where you will be responsible for managing new enrollments, providing exceptional customer service, and handling inquiries from our call center. This is a fantastic opportunity for someone with a background in medical claims administration who is looking to leverage their skills in a fast-paced, innovative environment.

Candidates must reside in one of the following states: Florida, Georgia, Virginia, Pennsylvania, Ohio, Tennessee, Alabama, Illinois, Minnesota, Arkansas, Texas, Colorado, California, Washington

Responsibilities:
As a Medical Claims Contract Administrator, your key responsibilities will include:

1. Managing and processing new enrollment applications, ensuring all necessary documentation is received, and data is accurately entered into our system.
2. Providing top-notch customer service, resolving any issues or concerns raised by our clients and ensuring they have a positive experience.
3. Working closely with our call center team, handling inquiries and complaints, providing necessary information, and escalating issues as needed.
4. Ensuring all medical claims are processed accurately and in a timely manner, adhering to all contractual obligations.
5. Maintaining up-to-date knowledge of all contractual changes and updates, ensuring all claims are processed in accordance to these.
6. Collaborating with other departments to ensure seamless service delivery and client satisfaction.
7. Identifying opportunities for process improvements, making recommendations, and implementing changes as approved.
8. Ensuring compliance with all company policies, as well as local, state, and federal regulations.

Qualifications:
The ideal candidate for this role will have the following qualifications:

1. A minimum of 2 years of experience in medical claims administration, preferably within the manufacturing industry.
2. Demonstrated experience in new enrollment processes and customer service.
3. Proven experience in a call center environment, with excellent communication skills and the ability to handle high-pressure situations.
4. Strong knowledge of medical terminology, coding, and billing procedures.
5. Exceptional attention to detail, with the ability to manage multiple tasks and deadlines.
6. Proficiency in using computer systems and software, including Microsoft Office suite and database management.
7. Excellent problem-solving skills, with the ability to think critically and make decisions.
8. Ability to work independently, as well as part of a team.
9. Bachelor's degree in healthcare administration, business, or a related field is preferred.

If you have a passion for helping others, an eye for detail, and a knack for problem-solving, we would love to hear from you. Join our team and play a key role in ensuring the smooth processing of medical claims and providing excellent service to our clients.