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CoxHealth is seeking a Contract Resolution Specialist to support network providers with contractual issues and to educate staff on CoxHealth contracts. The role emphasizes self-starting work, minimal supervision, and ability to travel for meetings as needed.
The position focuses on improving revenue cycle impact by ensuring contract terms are understood and followed, with on-site reviews and regulatory updates as part of daily duties.
Remote Missouri: 1423 North Jefferson Avenue, Springfield, Missouri, United States of America, 65802
1722 CoxHealth Network
40
8:00-5:00
Day Shift (United States of America)
CoxHealth is a leading healthcare system serving 25 counties across southwest Missouri and northern Arkansas. The organization includes six hospitals, 5 ERs, and over 80 clinics. CoxHealth has earned the following honors for workplace excellence:
The Contract Resolution Specialist primary function will be to assist network providers with any contractual issues. The Contract Resolution Specialist will also act as a trainer/educator of all CoxHealth Network contracts to the network providers and their staff. They must be a self-starter and work with minimal supervision. Some local travel is required along with organizing and hosting meetings when required. They will possess an in-depth working knowledge of managed care plans and CoxHealth contracts and how they pertain to successful operations of a hospital/provider's office. The responsibility of this position impacts the revenue cycle for approximately 40% of the provider's business. They must understand the legality of the messenger process CoxHealth Network uses for independent providers. They must be able to analyze and communicate contractual terms and their requirements to the provider. They will perform initial and recredentialing on-site reviews and chart audits for providers, as needed. Responsibilities include, but are not limited to; contract resolution, delivery and interpretation of policy and procedure changes as it relates to specific contracts, communication of regulatory changes as it relates to the insurance industry as needed, researching new technology with respect to payors medical necessity and coverage, Maintains contacts and provides educational information to network, tertiary/affiliate PHO networks that impact over 3000 providers/facilities. Able to organize, prioritize and multi-task to execute projects and day to day work flow.
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