Payer Relations Coordinator — Flexible Schedule & Contracts

Cape Fear Valley Health

Fayetteville, Northern (NC, KY)

Hybrid

USD 65,000 - 90,000

Full time

9 days ago

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Job summary

Cape Fear Valley Health is seeking a Contract Specialist to assist in developing and maintaining contractual relationships and to lead select projects. The role requires collaboration with employers, insurers, and physicians to ensure accurate reimbursement and timely contract changes.

Responsibilities include negotiation, reporting on reimbursement methodologies, and monitoring policy changes. A strong analytical mindset, clear communication, and leadership are essential for success in this

Qualifications

High school diploma or equivalent required.
Bachelor’s degree preferred OR 8 years of experience preferred.
3 years medical business experience in a related field or managed health care experience preferred.

Responsibilities

Assist and, in some cases, lead negotiating and maintaining managed care contracts.
Coordinate reporting that analyzes reimbursement methodologies and rates to determine payment accuracy.
Assist in developing, implementing and maintaining a system of renewal and reporting to monitor contract status and viability.
Work with internal and external stakeholders to ensure loading of contract changes.
Monitor Managed Care websites for any policy changes.
Work with PFS to determine appropriate claims for escalation and with Payers on appeals of denial.