Contracts Analyst

Prime Healthcare; Ontario (CA); On-site; USD 34,000 - 39,000; Full time

Benefits offered by this job

401K retirement plan

Medical, dental, and vision coverage

Paid time off

Tuition reimbursement

Job summary

Prime Healthcare in Ontario, CA is seeking a Contracts Analyst to originate and maintain physician and provider contract packets, LOAs, and manage submission/approval workflows. You will maintain provider files and amend contracts as needed, ensuring accuracy and compliance.

Qualifications include CPT/ICD-10 and managed care contracts knowledge, experience with self-funded plans, and strong communication with physicians and vendors.

Qualifications

• High School diploma or GED.
• Knowledge of physician credentialing, CPT, ICD-10, and managed care contracts.
• Experience with self-funded medical plans.
• Proficient in Microsoft Office.
• Ability to interact professionally with physicians and vendors.
• Strong follow-up skills.

Responsibilities

• Originate and maintain physician and provider contract packets and LOA.
• Track submission and approval processes for contracts.
• Maintain contact files and amend contracts as appropriate.
• Expand our network of providers and recommend actions for missing providers.
• Handle confidential information with discretion and professionalism.
• Perform special projects as assigned.

Skills

Physician credentialing

CPT/ICD-10 knowledge

Managed care contracts

Self-funded plans

Microsoft Office

Professional communication

Education

Associate's degree

Tools

Microsoft Office

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Contracts Analyst originates and maintains physicians and providers contract packets, Letter of Agreements (LOA), tracks submission and approval process, maintains and updates contact files and amends contracts as appropriate for the self-funded medical plan (EPO). Requires a high level of responsibility, confidentiality, judgment and discretion in applying department policies, procedures and handling confidential information. Communicate effectively, in writing, verbally and via telephone. Expand our network of providers, and make recommendation for management for lacking or contracted providers within Prime network. Performs special projects as assigned by the Corporate Director of Employee Health (EPO).

Qualifications

Required qualifications:

• High School Graduate or GED.
• Working Knowledge of physician credentialing process, and strong follow-up skills.
• Knowledge of CPT, ICD-10 codes, Medicare guidelines, and Managed Care contracts.
• Working knowledge of self-funded medical plans and/or Managed Care plans.
• Computer literate in Microsoft Office Windows.
• Ability to interact professionally with physicians and vendors.

Preferred qualifications:

• Associate's degree from an accredited institution.

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to,

• paid time off
• a 401K retirement plan
• medical, dental, and vision coverage
• tuition reimbursement
• many more voluntary benefit options

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $24.77 to $28.25. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf