Payor Contract Administrator - Remote
Company: Disability Solutions
Location: Port Saint Lucie
Posted on: April 18, 2024
Job Description:
Work Location: Remote Candidates must reside in one of the
following states: Florida, Georgia, Virginia, Pennsylvania, Ohio,
Tennessee, Alabama, Illinois, Minnesota, Arkansas, Texas, Colorado,
California, Washington You Will (Responsibilities): The Contract
Administrator provides oversight, management, coordination,
organization, and communication of payor contracting activities for
each of the ABC Medical family of companies. The Contract
Administrator is responsible for maintaining all company payer
agreements, addendums, renewal terms, and required notification or
due dates. The position interprets all payer requirements and
ensures that those requirements are systematically implemented in
company operating processes. The Contract Administrator manages the
payer contract process and collaborates with the sales team and
internal departments to ensure staff are informed of contracting
status. Key factors include supporting the sales growth by
developing new contracts with payers and expanding contract
coverage to pursue profitable business growth.
- Pursue, negotiate, and maintain contracts with all payers,
e.g., insurance companies, IPAs, TPAs and government programs.
- Understand insurance policies and regulatory guidelines to
implement systematic parameters to ensure compliance with
payer-specific rules and requirements.
- Provide expertise and support to internal departments regarding
specific payer guidelines and contractual inquiries.
- Understands and identifies profitability opportunities within
assigned payers.
- Facilitate the payer contracting process and ensure accuracy of
all contract documents from pre-contract through post-contract
phases.
- Works with legal, credentialing and all relevant involved teams
to ensure contracts are compliant.
- Provides contract summaries and ensure contract execution in
accordance with company policy.
- Supports providing a monthly report to senior management and
organizational stakeholders with progress and status of contracted
payor agreements.
- Supports the maintenance of a common provider
directory/database for enrollment with payers.
- Supports the research of territories to identify gaps in payer
base to support contract expansion.
- Assist with all contracting administration and projects, as
needed. Minimum Qualifications:
- Associate or bachelor's degree, or 5 years of relevant
healthcare contract experience
- Ability to interact professionally and ethically with team
members, all levels of management, government agencies, and
insurance payer personnel
- Ability to manage multiple tasks simultaneously in a fast-paced
environment
- Ability to provide clear, concise oral and written
communications
- Ability to handle special requests in a sensitive, professional
manner
- Strong attention to detail and follow through skills
- Meticulous organization and filing skills Preferred
Qualifications:
- Experience working at a medical insurance company, IPA, TPA
highly preferred
- Familiarity and experience with DME and/or Medical Supply
reimbursement, including Medicare, Medicare Managed, Medicaid, and
Medicaid Managed plans.
- Knowledge and use of Brightree software preferred but not
required.
- Advanced Microsoft Office experience
- Ability to troubleshoot complex payor events Here's what we
have to offer:
- Variety of Medical, Dental and Vision Insurance Plans
- 401k Plan with Company Match
- PTO and Paid Holidays
- EAP
- Employee Discounts Pay Transparency Statement: The anticipated
base salary range for this position is $55,190 - $102,496. The
actual salary varies based on applicant's location, education,
experience, skills, abilities, and other legitimate business
factors. The Company also provides a unique Benefit of Employee
Share Ownership Program (BESOP) program.
- The Company's health and welfare benefits include: medical,
prescription, dental, vision, spending/savings accounts,
disability, statutory leaves/disability programs, accident, life,
wellbeing, and voluntary benefit programs.
- The Company's 401(k) Retirement Savings Plan includes: vesting
and eligible participants "safe harbor" matching
contributions.
- The Company's paid time off benefits include: 8 paid holidays
and paid vacation based on length of service and exempt/non-exempt
status. To make life more rewarding and dignified for the people
who use our products and services.
Keywords: Disability Solutions, Port St. Lucie , Payor Contract Administrator - Remote, Other , Port Saint Lucie, Florida
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