Credentialing Specialist

Lensa; United States; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading company in community-based services is looking for a Contracts and Payor Specialist to join their mission-driven team. The position is responsible for securing public and private insurance contracts while fostering relationships with strategic partners. Ideal candidates will have a Bachelor’s degree and experience in the health insurance field, contributing to impactful work that changes lives.

Benefits

Full compensation/benefits package for employees working 30+ hours/week

401(k) with company match

Paid time off and holiday pay

Career development and advancement opportunities

Qualifications

• 3-5 years’ experience with contracts, managed care, and health insurance industry preferred.
• Reliable, responsible attitude and a compassionate approach.
• Commitment to quality in everything you do.

Responsibilities

• Identify and secure public/private insurance contracts.
• Analyze financial aspects of existing contracts.
• Manage contract negotiations and relationships with payors.

Skills

Analytical Skills

Negotiation Skills

Communication Skills

Education

Bachelor’s degree in Rehabilitation Administration, Business Administration or related field

Job description

2 days ago Be among the first 25 applicants

Lensa partners with DirectEmployers to promote this job for Sevita.

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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