Strategic Payer Contract & Credentialing Specialist

North Shore Healthcare; Milwaukee (WI); On-site; USD 34,000 - 49,000; Full time

Benefits offered by this job

Up to $30/hr based on experience

Supportive Team

Growth Potential

Job summary

North Shore Health is seeking a Payer Contract and Credentialing Specialist to oversee contract matrices, credentialing, and related workflows at our Support Center. You will coordinate internal reviewers, track deadlines, and ensure timely submissions for multiple facilities and payers.

Requirements include at least 2 years in an office setting, strong Excel skills, and a Bachelor’s degree in healthcare administration or related field preferred.

Qualifications

• At least 2 years of professional work experience in an office environment.
• Proficiency in Microsoft Excel, including sorting, filtering, formulas, and reconciliation of detailed records; ability to learn payer portals and maintain organized shared documents.
• Strong written and verbal communication skills, with the ability to manage competing priorities and work independently across multiple facilities and payers.

Responsibilities

• Maintain the centralized payer contract matrix by facility, including legal entity, payer and product participation, network status, NPI, tax ID, reimbursement terms, effective dates, renewal dates, and termination or notice deadlines.
• Validate entries against executed agreements, amendments, payer confirmations, and approved facility records. Identify and resolve discrepancies with the appropriate owner.
• Maintain an organized repository of executed agreements, amendments, rate schedules, credentialing records, and related correspondence, with clear version control.
• Update contract records following approved changes and provide current participation information to Admissions, Revenue Cycle, and facility leadership.

Skills

Written and verbal communication

Ability to manage multiple facilities

Education

Bachelor’s degree in healthcare administration or related field

Tools

Microsoft Excel

Job description

North Shore Health is seeking a Payer Contract and Credentialing Specialist to oversee contract matrices, credentialing, and related workflows at our Support Center. You will coordinate internal reviewers, track deadlines, and ensure timely submissions for multiple facilities and payers.

Requirements include at least 2 years in an office setting, strong Excel skills, and a Bachelor’s degree in healthcare administration or related field preferred.