BilliMDposted 6 months ago
$42,386 - $46,546/Yr
Full-time • Mid Level
Doral, FL
11-50 employees

About the position

The Contract Negotiation Specialist is responsible for negotiating and managing contractual agreements with insurance companies, healthcare networks, and other third-party payers. This role requires a comprehensive understanding of healthcare contracts and reimbursement structures to secure optimal terms and rates for BilliMD's providers. The specialist will collaborate closely with the Credentialing and Billing teams to ensure that all contract agreements align with regulatory requirements and support BilliMD's strategic objectives.

Responsibilities

  • Initiate, negotiate, and finalize contracts with insurance payers, healthcare networks, and other entities, focusing on favorable terms for reimbursement and service agreements.
  • Conduct thorough analysis of proposed rates and terms, comparing them against industry standards to identify areas for improvement.
  • Assist in the enrollment process for new providers, ensuring contract terms align with credentialing requirements and supporting seamless onboarding.
  • Build and maintain strong relationships with insurance representatives and payer contacts to facilitate ongoing negotiation efforts and contract renewals.
  • Review and interpret contract language, ensuring compliance with all regulatory and legal requirements, and minimizing risks for BilliMD.
  • Monitor contract performance, reimbursement trends, and payer compliance, preparing reports to inform leadership of key insights and opportunities for renegotiation.
  • Work closely with the Credentialing, Billing, and Operations teams to ensure cohesive contract implementation and address any issues that arise post-signing.
  • Address and resolve any discrepancies or conflicts in contract terms, reimbursement disputes, or other payer-related issues.
  • Track contract expiration dates and initiate timely renegotiation or amendments to maintain continuous and favorable payer relationships.

Requirements

  • Minimum of 3 years of experience in healthcare contract negotiation, reimbursement, or a related field.
  • Bachelor's degree in healthcare administration, business, or a related field preferred.
  • Strong negotiation and communication skills with a proven record in contract negotiation.
  • Analytical skills with proficiency in data analysis and interpretation.
  • Ability to understand complex contract language and healthcare regulatory standards.
  • Detail-oriented with excellent organizational skills.
  • In-depth knowledge of healthcare contracting, reimbursement methodologies, and payer networks.

Nice-to-haves

  • Negotiation: 4 years (Preferred)

Benefits

  • Health insurance
  • Paid time off
  • Flexible scheduling
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