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Contracting and Credentialing Specialist - Philippines

Forta

Forta

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See open jobs at Forta.
Administration
Philippines
Posted on Tuesday, December 5, 2023
FORTA’S MISSION:
Forta is clearing the path to quality healthcare by delivering the best possible outcomes with the utmost convenience. 1 in 36 children [CDC, 2023] is diagnosed to be on the autism spectrum. Currently, autism support via Applied Behavior Analysis (ABA) is difficult to access and the delivery model must be expanded to provide earlier access to families.
Forta is not only providing ABA services to our clients, but we’re also improving the future of the ABA experience for families by creating software and predictive algorithms that elevate clinicians to work smarter by surfacing the latest and most relevant case data. We are working diligently to continuously improve the patient journey and deliver personalized care by applying smart technology and investing in the growth of our world-class team.

Responsibilities:

  • Provide expert knowledge and advice on group contracting and clinician credentialing processes, regulations, and best practices.
  • Assist in the development and negotiation of contracts with payors, ensuring favorable terms and conditions.
  • Review and evaluate payor contracts to identify opportunities for improvement, cost savings, and revenue enhancement.
  • Collaborate with internal stakeholders to ensure that payor contracts align with organizational goals and objectives.
  • Stay up-to-date with industry trends, changes in regulations, and emerging issues related to contracting and credentialing.
  • Educate and train team members on group contracting and clinician credentialing processes, policies, and procedures.
  • Serve as the primary point of contact for inquiries related to payors.

Requirements:

  • Bachelor's degree in healthcare administration, business, or a related field
  • Monday.com experience is highly desired
  • Strong knowledge of payor reimbursement methodologies, contract negotiation strategies, and industry regulations.
  • Excellent understanding of contracting and credentialing processes, including provider enrollment, privileging, and payor landscape.
  • Proven ability to analyze and interpret payor contracts and financial data.
  • Exceptional communication skills, both written and verbal, with the ability to articulate complex concepts to diverse audiences.
  • Strong interpersonal skills and the ability to collaborate effectively with cross-functional teams.
  • Detail-oriented with excellent organizational and time management skills.
  • Ability to work independently and handle multiple projects simultaneously.
Apply Today!
We are looking for you! A driven, innovative, client-focused individual to join our team as we innovate the care and tools available to neuro-diverse families. If this position sounds like the opportunity you have been searching for, we want to speak with you!
We look forward to working with you!
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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Forta is a Drug-Free Workplace/ EO employer – M/F/Veteran/Disability.

This job is no longer accepting applications

See open jobs at Forta.