Contracting Specialist

NorthShore Health Centers; Portage (IN); On-site; USD 55,000 - 75,000; Full time

Job summary

NorthShore Health Centers is seeking a Contracting Specialist to manage initial and re-credentialing of providers and locations. This role ensures timely processing of contracts with Medicare, Medicaid, and commercial plans while maintaining directory updates across multiple portals.

The position requires deep regulatory understanding, strong organizational skills, and the ability to communicate with internal teams. Office-based with occasional travel within locations.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, or related studies.
• Master’s degree in Healthcare Administration, Business, or related studies.
• Two years of experience working within a healthcare setting.

Responsibilities

• Complete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.
• Maintain and update payer/product directories monthly and quarterly via portals such as Availity, LexisNexis, Better Doctor.
• Navigate Medicaid, NPPES, CAQH and related sites for providers and locations as needed.
• Create new CAQH profiles and attest quarterly for all providers.
• Enroll new NorthShore locations in Medicare, Medicaid, and plans; enroll NPIs.
• Communicate status of insurance contracts with NorthShore staff; other duties as assigned.

Skills

Analytical thinking

Interpersonal skills

Customer service

Regulatory knowledge

Organizational planning

Critical thinking

Emotional intelligence

Ethical judgment

Attention to detail

Verbal communication

Written communication

Time management

Prioritization

Sense of urgency

Feedback receptiveness

Education

Bachelor’s degree in Healthcare Administration, Business, or related studies

Master’s degree in Healthcare Administration, Business, or related studies

Tools

Microsoft Office Suite

Job description

Summary/ObjectiveThe Contracting Specialist will be a member of the NorthShore Health Centers team and will be responsible for timely processing and completion of initial/re-credentialing insurance contracts for all NorthShore providers and locations.Essential FunctionsComplete provider initial and re-credentialing applications, provider demographic update forms, and letters for Medicare, Medicaid, managed care plans, and commercial insurances.Maintain and remain in compliance with payer and product directory updates monthly and quarterly through portals such as Availity, LexisNexis, Better Doctor, and other validation tools.Utilize and navigate Medicaid, NPPES, CAQH and additional sites/portals for providers and NorthShore locations as they are needed.Construct new provider CAQH profiles, update current CAQH applications, and attest the CAQH profiles quarterly for all providers.Create new NorthShore location NPIs and enroll the new locations in Medicare, Medicaid, managed care plans, and commercial insurances.Communicate with the appropriate NorthShore staff on the status of insurance contracts as needed.Performs other duties as identified or assigned.*These essential functions are a summary of the primary duties and responsibilities of the position and are not intended to be a comprehensive listing of all duties and responsibilities. The position will include other duties as assigned, and duties are subject to change at management's discretion.CompetenciesPlanning and strategic foresightResponsible Decision MakingIntegrity and accountabilityInnovation and creativityAdaptive and flexibleLeadership, teamwork, and conflict resolutionProfessionalism and work ethicEmpathyWork EnvironmentWork is performed in an office environment. Involves frequent personal and telephone contact with patients, physicians, and other healthcare personnel. Work may be stressful at times. Interaction with others is constant and interruptive.TravelTravel within Northshore locations will be rare for this position. Travel outside of Northshore locations will be rare for this position.Required Role QualificationsBachelor’s Degree in Healthcare Administration, Business, or related studiesPreferred Role QualificationsMaster’s Degree in Healthcare Administration, Business, or related studiesTwo years of experience working within a healthcare settingRequired SkillsAbility to analyze situations and solve problems at strategic and tactical levelsExcellent interpersonal and customer service skillsAbility to comprehend, interpret, and apply the appropriate sections of applicable laws, guidelines, regulations, ordinances, and policiesAbility to acquire a thorough understanding of the organization's hierarchy, jobs, qualifications, compensation practices, and the administrative practices related to those factorsPracticed at organization and planningEmploy Critical thinking and problem solvingMaintains composure and operates with emotional intelligenceEthical reasoning and decision-makingStrong attention to detailReceptive and responsive to feedbackExcellent verbal and written communication skillsTime management, prioritization, and sense of urgencyProficient with Microsoft Office Suite or related software