Healthcare Contracting Specialist
We are growing and are seeking an experienced Healthcare Contracting
This position is responsible for the negotiation of Contracts, Single
Payer Agreements, Appeals, and Balance Bills with provider practices,
facilities, and hospital networks.
The ideal candidate will bring their experience with negotiating
"Out-of-Network charges" as a Payor or Provider Representative.
Specific Job Responsibilities:
* Negotiate the terms of provider contracts
* Update or terminate existing contracts as necessary
* Assist with contract drafting
* Update information and documentation in our system
* Ensure provider compliance with contract terms and
* Ensure organizational compliance with contract terms
* Perform and manage provider appeal process
* Manage the balance bill process, liaise with
third-party law firms to defend members against balance bills.
* Perform additional duties as assigned.
Knowledge, Skills, and Abilities:
* Working knowledge of Provider Reimbursement and Payment methodologies
* Knowledge of medical terminology, medical coding,
* Strong negotiating skills
* Excellent organizational and time management skills
* Strong attention to detail
* Able to work comfortably in a fast-paced environment
* Excellent interpersonal, written, and oral
* Strong proficiency in Microsoft Office software, (i.e.,
MS Word, Excel)
* Ability to work effectively independently and as part
of a team
* Ability to take initiative, identify and address tasks
without prompting, meet deadlines, and follow through on assignments?
* Strong work ethic required.
We are an Affirmative Action - Equal Opportunity Employer
(Minorities/Females/Vets/Disabled). We provide equal opportunities to
all employees and applicants for employment without regard to sex,
race, color, religion, marital status, national origin, age, genetic
information, sexual orientation, gender (including gender
identity/expression), disability, veteran status and military status,
pregnancy or pregnancy-related medical conditions, or any other factor
that may be protected by law.
Covid-19 Precautions: We are asking that all
interested candidates be vaccinated with having obtained at least one
part of the vaccination prior to starting with us and having the 2nd
shot within the first 30 days of employment.