EmblemHealth

Senior Contract Specialist - Remote


PayCompetitive
LocationNew York/New York
Employment typeFull-Time

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  • Job Description

      Req#: 6689
      Employer Industry: Healthcare

      Why consider this job opportunity:
      - Salary up to $99,360
      - Opportunity for career advancement and growth within the organization
      - Collaborative work environment with cross-departmental interaction
      - Chance to serve as a subject matter expert in contract configuration and reimbursement processes
      - Strong focus on detail-oriented tasks and problem-solving opportunities
      - Supportive employer culture that values organizational and analytic skills

      What to Expect (Job Responsibilities):
      - Oversee the accurate loading of provider, facility, and ancillary contracts into the NetworX system
      - Collaborate with Network Management and Analytics to ensure contracts are accurately captured and maintained
      - Identify and resolve any rate load problems associated with contract configurations
      - Analyze contracts to ensure reimbursement aligns with negotiated agreements
      - Coordinate updates for evergreen contracts across all relevant departments

      What is Required (Qualifications):
      - B.S. degree in Business Operations, Information Systems, or a related field
      - 3-5+ years of relevant experience, preferably in a healthcare environment
      - Strong familiarity with claims systems and related applications
      - Experience in managing provider, facility, and ancillary contract files, including testing and auditing
      - Excellent knowledge of medical terminology, Fee Schedules, and coding systems (ICD/CPT/HCPCS)

      How to Stand Out (Preferred Qualifications):
      - Additional experience or specialized training may be considered in lieu of educational requirements
      - Understanding of Government reimbursement methodologies
      - Strong communication skills with the ability to engage diverse audiences
      - Proficiency in MS Office applications, including Word, Excel, PowerPoint, Outlook, Teams, and SharePoint

      #Healthcare #ContractManagement #CareerOpportunity #AnalyticalSkills #ProblemSolving

      "We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately. 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.