What are the responsibilities and job description for the Contract & Claims Management Specialist position at PACE of Guilford & Rockingham?
Under the direction of the Business Office Manager, the Contract & Claims Management Specialist is responsible for developing, processing and evaluating contracts and out-of-network agreements for medical and non-medical providers. This includes the responsibility of assuring contractor orientation to PACE, quality improvement involvement, participant satisfaction, and evaluation of contractor service. This position is also responsible for all aspects of claims processing ensuring that payment is processed according to contract agreement and organization policy and procedure. This position serves as back up to Business Office Manager and Billing Specialist.
With or without reasonable accommodations: Able to read, write and speak English; ability to clearly see contracts and billing statements and other various documents; ability to perform repetitive hand/wrist movements; requires sitting and standing associated with a normal office environment; manual dexterity needed for using a calculator and computer keyboard; responsibilities, skills and working conditions may change as needs evolve.