Create and maintain relationships with medical profession community
Recruit new provider and perform provider contracting activities including fee negotiation, cost containment, quality review, orientation, clinic accreditation to meet with selection requirement and credential process
Compromise and reach an agreement with provider as approved by manager independently
Understand and reinforce the need of compliance to the existing agreement terms and conditions
Assist the manager on daily operation to ensure all tasks identified function appropriately
Prepare and issue contract for authorized signature and follow up on contract return
Process contracting activities: new ,renew, extension and termination align with company’s policy; verify supporting documents and required information; update at designated company application
Provide training , consolidated feedback and provide enquiry support in related to provider agreement
Process and follow up request from internal stakeholders
Review and monitor provider performance to ensure provider comply with cost control, quality review and other administrative guidelines
Make termination recommendations to Manager for final approval of provider performance not acceptable
Make effective use of historical and other benchmark data to ensure competitive pricing with contacted providers
Verify data for daily work from various reports including daily , monthly report to ensure high accuracy rate of processing
Work closely with claims team and provider for the improvement of claims payment processing efficiency
Execute effective communications with related teams and network providers as required
Communicate effectively with internal stakeholders in order to gain their support with the healthcare strategy
Follow up enquirers from providers and other teams reacted to network providers
Comply with the set KPI, job duties and department guidelines
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