Payer Contract Administrator (Remote)

This position provides support and administration for the payer contracting team to implement and maintain payer contracts. The position's primary focus will be ensuring all payer contract terms and conditions are adhered to, including issue identification, escalation, and resolution, while keeping the contract repository system current.

This position requires an individual passionate about process improvement and project management, with a high degree of independence, self-motivation, competency, efficiency, and professionalism.

Primary responsibilities of this position include:

• Serve as the department system administrator to ensure all documents associated with payer agreements are in the contract repository system and perform audits regularly to ensure accuracy.

• Assist with letters of agreement and single case agreements for specialty services.

• Initiation and completion of department checklists for all contract changes.

• Creates and maintains tools for the organization to use that reference the contract terms and the contract reimbursement.

• Assist in distributing pertinent contract information to the appropriate key stakeholders.

• Collaborate closely with the contracting team to assist in resolution of identified issues.

• Prepare legal letters and documentation necessary for contractual notifications.

• Consult with other Renown departments to assess if contract terms are being followed.

• Continuous learning of managed care principles is required to support the day-to-day activities related to payer projects.

• Must have the ability to take initiative and exercise independent decision-making.

• Regular audits of insurance provider directories.

• Assist in gathering legal document, payer policies and reporting for payer contracting.

• In addition, this position requires critical thinking skills and strong communication skills to independently interact with operational department leaders and initiate or assist operational improvements required in order to comply with law or regulation and/or in order to improve interdepartmental operational efficiency.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor’s degree in business healthcare related field, business or financial degree, or proven experience in a similar role required

Experience:

Three to Five (3-5) years of healthcare experience in a managed care environment. Prior experience may include anything within the Revenue Cycle, Contracting, Health Insurance and/or Provider Relations.

License(s):

None

Certification(s):

None

Computer / Typing:

Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.