EmblemHealth
Contract Specialist, Configuration - Remote
This job is now closed
Job Description
- Req#: 6850
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $83,160
- Opportunity for career advancement and growth within the organization
- Collaborative work environment with cross-departmental interaction
- Chance to contribute to the accuracy and efficiency of healthcare reimbursement processes
- Develop expertise in contract configuration and reimbursement methodologies
- Supportive employer committed to professional development
What to Expect (Job Responsibilities):
- Load all Professional, Facility, and Ancillary contracts accurately across all lines of business
- Collaborate with Network Management and Analytics to ensure proper capture of contractual agreements
- Identify and rectify any issues related to rate load problems
- Analyze negotiated contracts to ensure reimbursement aligns with contractual intent
- Coordinate rate testing and updates for evergreen contracts in a timely manner
What is Required (Qualifications):
- B.S. degree in Business Operations, Information Systems, or equivalent
- Minimum 2-3 years of relevant experience, preferably in a healthcare environment
- Strong familiarity with the employer's claims systems and interdependent applications
- Excellent knowledge of medical terminology, Fee Schedules, and ICD/CPT/HCPCS coding
- Understanding of Government reimbursement methodologies
How to Stand Out (Preferred Qualifications):
- Master’s Degree is a plus but not required
- Experience in provider, facility, and ancillary contract file setups, maintenance, testing, and auditing functions
- Proven ability to establish and accomplish business strategies for translating contractual language into system specifications
- Strong analytic and problem-solving skills
#HealthcareServices #ContractManagement #CareerOpportunity #CompetitivePay #ProfessionalDevelopment
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
EmblemHealth provides all our members the latest plan & health information, including GHI Insurance information. We are dedicated to helping you stay healthy, get well, and live better.
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