EmblemHealth
Contract Specialist - Remote
NewJob Description
- Req#: 6967
Employer Industry: Healthcare
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
- Engage in meaningful work that impacts provider reimbursement processes
- Chance to develop expertise in contract configuration and reimbursement methodologies
What to Expect (Job Responsibilities):
- Load all Professional, Facility, and Ancillary contracts accurately and timely across all lines of business
- Collaborate with Network Management and Analytics to ensure accurate capture of contractual agreements
- Identify and correct issues related to rate loads
- Analyze negotiated contracts to ensure reimbursement aligns with negotiated terms
- Coordinate rate testing and updates for evergreen contracts
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
- Experience in setting up, maintaining, testing, and auditing provider, facility, and ancillary contract files
- Excellent knowledge of medical terminology, Fee Schedules, and ICD/CPT/HCPCS coding
How to Stand Out (Preferred Qualifications):
- Master’s Degree in a relevant field
- Experience in establishing and accomplishing business strategies for translating contractual language into reimbursement specifications
- Understanding of Government reimbursement methodologies
- Strong analytical and problem-solving skills
#Healthcare #ContractManagement #CareerOpportunity #CompetitivePay #HealthcareAdministration
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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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