Credentialing Specialist

Lensa; United States; Remote; USD 40,000 - 55,000; Full time

Job summary

A U.S. career site is seeking a Contracts and Payor Specialist for a remote position to manage public and private insurance contracts. This role involves collaboration with Program Directors, conducting negotiations, and maintaining contract compliance while ensuring high-quality support for individuals with intellectual disabilities.

Benefits

401(k) with company match

Paid time off and holiday pay

Full compensation package for employees working 30+ hours/week

Job security with career development opportunities

Qualifications

• Bachelor’s degree in relevant field preferred.
• 3-5 years of experience with contracts in the health insurance industry.
• Reliable and responsible attitude.

Responsibilities

• Identify and secure public and private insurance contracts.
• Analyze financial aspects of contracts and maintain documentation.
• Conduct rate and contract negotiations with potential payors.

Skills

Analytical Skills

Negotiation

Communication

Education

Bachelor’s degree in Rehabilitation Administration or Business Administration

Job description

3 days ago Be among the first 25 applicants

Lensa is a U.S. career site that helps job seekers discover job opportunities. We are not a staffing firm or agency. We promote jobs on behalf of our clients, which include employers, recruitment agencies, and marketing partners.

SEVITA provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You’ll join a mission-driven team and create relationships that motivate us all every day. Join us today, and experience a career well lived.

Contracts and Payor Specialist - REMOTE

The Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assists with the development of potential relationships with strategic partners and creates measurable business results for various markets.

Contracting and Credentialing

• Works in partnership with Program Directors and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts
• Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts
• Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants
• Conducts rate and contract negotiations
• Describes CFS programs to potential contract sources
• Communicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are met
• Completes contract related credentialing and enrollment application requirements
• Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment application
• Oversees Single Case Agreement process within the Admissions Teams. May take lead in difficult single case negotiation
  
  

Other Duties

• Communicates contract executions and requirements to all internal departments
• Facilitates resolution of contract related issues with billing and collections team
• Performs other related duties and activities as required
  
  

Qualifications

• Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred
• Three to five years’ experience with contracts, managed care, and health insurance related industry preferred
• A reliable, responsible attitude and a compassionate approach
• A commitment to quality in everything you do
  
  

Why Join Us?

• Full time position
• Full compensation/benefits package for employees working 30+ hours/week
• 401(k) with company match
• Paid time off and holiday pay
• Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers
• Enjoy job security with nationwide career development and advancement opportunities
  
  

We have meaningful work for you – come join our team – Apply Today!

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  IT Services and IT Consulting

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