Healthcare Contracting Specialist
We are growing and are seeking an experienced Healthcare Contracting Specialist (Negotiator).
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 legal regulations
* 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, ICD-10, CPT4
* 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 communication skills
* 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.
* Bachelor’s degree in business administration, healthcare administration, or a relevant field
* At least 5+ years’ experience in contract drafting and/or negotiating
* At least 3+ years’ experience in a healthcare environment
* Supervisory/Relationship Management experience preferred
* Hospital/Out of Network negotiator experience ideal
Source: Monster.com
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