Payor Strategy Contract Coordinator

This is a fully remote position, open to applicants in Florida, +4 more states.

📋 Description

• Oversee managed care contract administration across all Trident business entities.

• Report directly to the Senior Manager of Revenue Cycle Management, Payer Strategy.

• Collaborate with Management Team members and the Sales team to pinpoint contracting and business opportunities.

• Assess contracts for efficiency and profitability.

• Operationalize contracts and audit payments for accuracy across all business lines.

• Manage the contractual process, including the submission and response of managed care proposals and payer documentation.

• Act as the primary liaison for regional payors.

• Maintain electronic records of signed contracts in compliance with federal, state, and local regulations.

• Define contract provisions and evaluate rate impacts.

• Support the Reimbursement team with audits and inquiries from non-government payors.

• Review proposals and responses with the Senior Manager for approval.

• Collaborate with System Support to upload and test fee schedules and new filing formats.

• Distribute Health Plan Contracting Announcement Forms to relevant personnel.

• Document contract terms, fee schedules, and billing requirements.

• Keep fee schedules up to date in line with contractual agreements.

• Communicate new and amended contracts to internal departments.

• Audit processes to ensure optimal status.

• Develop and execute contract documents that align with annual strategies.

• Prepare opportunity analyses for pricing and network decisions, both in-network and out-of-network.

• Assess contract profitability and renegotiate or terminate contracts as needed.

• Maintain payor participation lists for billing and sales teams.

• Create solutions for payor and contract-related challenges with Billing Management.

• Identify problematic payors and reimbursement trends that impact cash collections.

• Educate internal and external clients on exceptional payer requirements.

• Pursue payor contracts based on volume, payments, collection percentages, and sales opportunities.

• Serve as a liaison between Billing Accounts Receivable and payor relations when contractual Accounts Receivable issues arise.

• Perform additional duties as assigned.

⛳️ Requirements

• Minimum of 3 years of experience in contracting.

• At least 4 years of experience in healthcare billing or accounting is required.

• High School Diploma is required.

• Experience with contract management software is preferred.

• Comprehensive understanding of managed care programs for non-government payor relations.

• Excellent verbal and written communication skills are essential.

• In-depth knowledge of payer dynamics, including value-based care models and healthcare regulations.

• Demonstrated success in contract negotiation and managing comprehensive sales processes.

• Ability to meet deadlines and manage multiple customer service demands from both internal and external clients.

• Strong attention to detail is necessary.

• Goal-oriented mindset.

• Capability to multitask in a fast-paced environment while managing multiple deadlines.

• Proficient in Microsoft Office Suite, including Excel, Word, and PowerPoint.

• Intermediate skills in Microsoft Office.

• Advanced proficiency in English, both written and verbal.

• Advanced computer skills are required.

• Intermediate typing skills, with a minimum speed of 35 wpm.

• Internet access is required.

• Must be a team player.

• Detail-oriented approach is essential.

🏝️ Benefits

• Comprehensive health insurance.

• Retirement savings plan.

• Paid time off and holiday pay.

• Opportunities for professional development and advancement.