Payer Contracting Specialist

WHAT YOU WILL DO
Review and maintain payer contracts, amendments, fee schedules, and reimbursement terms for provider clients

Track contract effective dates, renewal timelines, and required updates

Analyze reimbursement terms, payment rates, and contract provisions relevant to client billing

Support payer contract negotiations and renewals by preparing documentation and relevant financial information

Coordinate with provider clients and internal RCM teams on contract-related questions and requirements

Communicate changes in payer contracts and reimbursement terms to billing, coding, and revenue integrity teams

Maintain organized and accurate records of payer agreements and related documentation

Identify potential discrepancies between contract terms and operational billing or reimbursement practices

Support research into payer policies, contract provisions, and reimbursement requirements

WHAT WE ARE LOOKING FOR
2+ years of experience in payer contracting, healthcare revenue cycle management, healthcare administration, or a related field

Understanding of healthcare payer contracts, reimbursement terms, and provider participation agreements

Experience reviewing contracts, fee schedules, and reimbursement information

Strong analytical and attention-to-detail skills

Ability to interpret contract language and translate relevant requirements into clear operational guidance

Strong communication skills and ability to work with payers, provider clients, and internal RCM teams

Strong organizational skills and ability to manage multiple contracts, deadlines, and priorities

Ability to work independently and effectively in a fully remote environment

HIPAA-compliant private workspace

NICE TO HAVE
Experience with Medicare, Medicaid, and commercial payer contracts

Experience with reimbursement analysis or revenue integrity

Knowledge of healthcare billing and coding processes

Experience with payer contract management or credentialing platforms

Experience working with provider groups or hospitals