COE Payor Relations & Contract Specialist

Northside Hospital Inc.; Atlanta (GA); On-site; USD 70,000 - 90,000; Full time

Job summary

Northside Hospital is seeking a Payor Development Specialist to operationalize COE contractual arrangements and support the payor development team within Managed Care. You will work closely with Contract Managers to manage COE negotiations, education, and process implementation.

You will help maintain payer relationships, review contracts, and resolve claim issues while supporting education for physician practices and COE mappings. Strong communication and analytical skills are essential.

Qualifications

• Bachelor's Degree or equivalent experience in healthcare or provider relations
• Strong understanding of reimbursement methodologies
• Strong understanding of claims adjustment processes and related activities
• Ability to work independently and communicate effectively

Responsibilities

• Maintain positive relationships with assigned COE payers and participate in COE negotiations
• Serve as liaison between billing staff, practices, and COE health plans to resolve claim issues
• Support contract management, fee schedule maintenance, and contract education for physicians
• Assist in COE application processes, provider mapping, and plan code mapping
• Act as primary contact/resource for assigned payers and ensure contract updates are implemented

Skills

Analytical skills

Communication skills

Organizational skills

Independent worker

Education

Bachelor's degree or equivalent experience

Tools

Microsoft Excel

Microsoft Access

McKesson Trendstar CPA

Job description

Northside Hospital is seeking a Payor Development Specialist to operationalize COE contractual arrangements and support the payor development team within Managed Care. You will work closely with Contract Managers to manage COE negotiations, education, and process implementation.

You will help maintain payer relationships, review contracts, and resolve claim issues while supporting education for physician practices and COE mappings. Strong communication and analytical skills are essential.