Payer Contracting Specialist
Core
Accelerate payer contracting efforts by managing provider data integrity, auditing payer directories, reconciling rosters, and resolving enrollment/credentialing escalations to ensure women's access to services.
Role type
Payer Contracting Specialist (Healthcare Operations)
Builds
Provider data integrity, payer directory accuracy, and durable internal references for payer requirements
Domain
US Healthcare / Payer Operations / Revenue Cycle
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Provider data management, revenue cycle operations, payer policy interpretation, root cause analysis, payer portal navigation, spreadsheet proficiency, documentation
Preferred skills
Payer portal/clearinghouse experience, denial management, credentialing standards familiarity, CPT/ICD-10 knowledge, multi-state telehealth experience
Technologies
Availity, plan-specific payer portals, clearinghouses, spreadsheet tools
Responsibilities
Own provider data integrity across systems; audit provider directories and chase corrections; reconcile rosters against payer records; research and interpret payer policies and manuals; codify payer requirements into internal references; support contracting and credentialing applications
Seniority
Early-career, hands-on IC