Payer Contract Specialist

Overview

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Position Summary

The Payor Contract Specialist : Responsible for managing the day-to-day responsibilities related to managed care contracting and payer / provider relations. This includes acting as the liaison between agencies and contracted health plans to disseminate information, research reimbursement and clinical policies, support provider credentialing and onboarding, and resolving claims and other payer issues.

Reports to : Compliance Contract Manager

Supervises : None

Qualifications

• Education : Bachelor's degree is required. Master's or Juris Doctorate degree is preferred.
• Experience : A minimum of 5 years' experience in a healthcare organization, to include demonstrated leadership in payor contracting. Familiarity with operational, financial, quality assurance, and human resource procedures and regulations is a must.
• Core Competencies : Knowledge and understanding of healthcare industry, legal and regulatory requirements. Exceptional and proven provider skills and interpersonal skills. Excellent contract negotiation skills. Results driven and able to self-direct. Strong organizational and analytical skills. Well-developed communication skills. Demonstrated strength in computer software, e.g., Excel, Microsoft Word, PowerPoint, etc.
• Other : Valid driver's license and auto insurance.

Responsibilities

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