Payor Strategy Contract Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee the contractual procedures for managed care proposals, letters of interest, and payor documentation.

• Act as the main point of contact for regional payors.

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

• Detail contract provisions and evaluate rate implications.

• 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.

• Prepare and distribute Health Plan Contracting Announcement Forms.

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

• Ensure that fee schedules are updated in accordance with contractual terms.

• Communicate new and revised contracts to internal departments.

• Regularly audit processes to maintain optimal status.

• Create and implement contract documents that align with annual strategies and company goals.

• Conduct opportunity analyses for pricing and decisions regarding in-network/out-of-network services.

• Assess and track contract profitability, including renegotiation or termination when necessary.

• Maintain payor participation lists for billing and sales teams.

• Develop solutions for payor and contract-related challenges in collaboration with the Billing Management Team.

• Identify problematic payors and reimbursement trends that adversely affect cash collections.

• Educate internal and external clients/customers about specific payer requirements.

• Actively seek out payors for contracts based on volumes, payments, collection percentages, and sales opportunities.

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

• Perform other assigned duties.

⛳️ Requirements

• A minimum of 3 years of contracting experience.

• At least 4 years of experience in healthcare billing/accounting.

• High School Diploma is required.

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

• Demonstrated success in contract negotiation and complete sales processes.

• Exceptional verbal and written communication skills.

• Capability to meet set deadlines and manage multiple internal and external customer service demands.

• Strong attention to detail.

• Goal-oriented.

• Ability to multitask in a fast-paced environment and manage various deadlines.

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

• Experience with contract management software is preferred.

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

• Intermediate skills in Microsoft Office.

• Advanced communication abilities.

• Advanced computer proficiency.

• Intermediate typing skills; a minimum of 35 words per minute.

• A collaborative team player.

• Detail-oriented.

• Internet access is necessary to perform job responsibilities.

🏝️ Benefits

• Remote work flexibility.

• Reasonable accommodations may be provided to enable individuals with disabilities to fulfill essential job functions.

• Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.