Medical Billing – Payer Strategy & Contracting Specialist

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteMid LevelTeam 1-10H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

9 days ago

Salary

Not specified

Seniority

Mid Level

High School2 yrs expEnglish

Job Description

• Responsible for supporting payer contract development, analysis, and strategy execution to ensure optimal reimbursement and compliance with payer requirements. • Conduct contract negotiation discussions on behalf of clients with payers • Assist in reviewing, interpreting, and maintaining payer contracts and fee schedules. • Support negotiation preparation by compiling rate comparisons and reimbursement trends. • Identify and escalate contract discrepancies impacting payment performance. • Collaborate with finance and AR teams to ensure payer terms are accurately reflected in billing systems. • Maintain payer-related documentation, amendments, and communication logs. • Provide input for payer performance reviews and support audits as needed. • Participate in payer meetings or calls to support strategic initiatives.

Job Requirements

  • High School Diploma or GED
  • At least two to four (2-4) years of medical billing and claims resolution experience preferred
  • AAHAM and/or HFMA certification preferred
  • Experience with offshore engagement and collaboration desired
  • Strong understanding of payer contracts, reimbursement methodologies, and healthcare compliance.
  • Familiarity with commercial and government payers in the US healthcare system.
  • Proficiency with Excel, payer portals, and contract management databases.
  • Become proficient in the use of billing software within 4 weeks and maintain proficiency
  • Ability to read, understand and apply state/federal laws, regulations, and policies
  • Ability to communicate with diverse personalities in a tactful, mature, and professional manner
  • Ability to remain flexible and work within a collaborative and fast-paced environment
  • Basic use of a computer, telephone, internet, copier, fax, and scanner
  • Basic touch 10 key skills
  • Basic Math skills
  • Understand and comply with company policies and procedures
  • Strong oral, written, and interpersonal communication skills
  • Strong time management and organizational skills
  • Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

Benefits

  • Ventra performance-based incentive plan
  • Referral Bonus

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