Contract Resolution Specialist

CoxHealth

United States

Remoto

USD 60.000 - 80.000

Tempo pieno

10 giorni fa
Generatore di candidature

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Vantaggi offerti da questo lavoro

Medical insurance
Vision insurance
Dental insurance
Employer retirement match

Descrizione del lavoro

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.

Competenze

  • 3–5 years of experience in provider office, healthcare billing or managed care.
  • Strong understanding of payor contracts and regulatory changes.
  • Experience with on-site reviews and chart audits.

Mansioni

  • Assist network providers with contractual issues.
  • Train providers on CoxHealth Network contracts and requirements.
  • Perform initial and recredentialing on-site reviews and chart audits.
  • Organize and host meetings; some local travel as required.

Conoscenze

Contract management
Contract analysis
Communication

Formazione

High School Diploma
Bachelor's degree

Descrizione del lavoro

Facility

Remote Missouri: 1423 North Jefferson Avenue, Springfield, Missouri, United States of America, 65802

Department

1722 CoxHealth Network

Scheduled Weekly Hours

40

Hours

8:00-5:00

Work Shift

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:

  • Named one of Modern Healthcare's Best Places to work five times.
  • Named one of America's Greatest Workplaces, Greatest Workplaces in Healthcare (2025, 2026), Greatest Workplaces for Women (2023, 2024), and Greatest Workplaces for Diversity (2024) by Newsweek and Plant-A Insights Group.
  • Acknowledged by Forbes as one of the Best Employers for New Grads.
  • Healthcare Innovation's Top Companies to Work for in Healthcare (2025).
Benefits
  • Medical, Vision, Dental, Retirement with Employer Match and more (20+ hrs/week)
Job Description

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.

Education
  • Required: High School Diploma or Equivalent
  • Preferred: Bachelors in a Related Field
Experience
  • Required: 3-5 Years experience working in the provider office, healthcare billing, healthcare insurance and/or Managed Care industry.
  • Preferred: Previous experience in provider relations and/or physicians office management.
Skills
  • Ability to understand complex multi-provider payor contract agreements and determine compliance standards are being adhered to.
Licensure/Certification/Registration

N/A

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