Payer Contract Administrator (Remote)
- Requisition ID
- 182647
- Department
- 100604 Contracting
- Schedule
- Full Time - Eligible for Benefits
- Shift
- Day
- Category
- Professionals
- Salary
- 32.76 - 45.87
Position Purpose
This position provides support and administration for the payer contracting team to implement and maintain payer contracts. The position's primary focus will be ensuring all payer contract terms and conditions are adhered to, including issue identification, escalation, and resolution, while keeping the contract repository system current.
This position requires an individual passionate about process improvement and project management, with a high degree of independence, self-motivation, competency, efficiency, and professionalism.
Nature and Scope
Primary responsibilities of this position include:
• Serve as the department system administrator to ensure all documents associated with payer agreements are in the contract repository system and perform audits regularly to ensure accuracy.
• Assist with letters of agreement and single case agreements for specialty services.
• Initiation and completion of department checklists for all contract changes.
• Creates and maintains tools for the organization to use that reference the contract terms and the contract reimbursement.
• Assist in distributing pertinent contract information to the appropriate key stakeholders.
• Collaborate closely with the contracting team to assist in resolution of identified issues.
• Prepare legal letters and documentation necessary for contractual notifications.
• Consult with other Renown departments to assess if contract terms are being followed.
• Continuous learning of managed care principles is required to support the day-to-day activities related to payer projects.
• Must have the ability to take initiative and exercise independent decision-making.
• Regular audits of insurance provider directories.
• Assist in gathering legal document, payer policies and reporting for payer contracting.
• In addition, this position requires critical thinking skills and strong communication skills to independently interact with operational department leaders and initiate or assist operational improvements required in order to comply with law or regulation and/or in order to improve interdepartmental operational efficiency.
This position does not provide patient care.
Disclaimer
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications
Requirements - Required and/or Preferred
Name | Description |
|---|---|
Education: | Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor’s degree in business healthcare related field, business or financial degree, or proven experience in a similar role required |
Experience: | Three to Five (3-5) years of healthcare experience in a managed care environment. Prior experience may include anything within the Revenue Cycle, Contracting, Health Insurance and/or Provider Relations. |
License(s): | None |
Certification(s): | None |
Computer / Typing: | Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. |
Benefits
Renown Health exists to make a genuine difference in the health and well-being of the people and communities we serve. And it is through your passion that this mission is made real every day. The relationship with employees is the foundation for success as we proceed with our strategic direction. We strive to build upon this solid partnership by offering a comprehensive and competitive benefits package that meets the diverse needs of employees and their family members.
With my CAREER Rewards there's peace of mind in knowing that Renown Health is also fighting for the most important things in your life - family, finances and future. Navigate options and make sure you are getting the most value from your Nursing career with us.
Paid Time Off
401(k) Company Match
Flexible Work Environment
Renown Health is northern Nevada's healthcare leader and Reno's only locally owned, not-for-profit health system. We are an entire network of hospitals, primary care offices, urgent care centers, lab services, medical specialties, and x-ray and imaging services - with more than 7,000 nurses, doctors and care providers dedicated to the health and well-being of our community.
For Providers: Renown Health and the University of Nevada, Reno School of Medicine (UNR Med) are affiliate partners in Nevada's first integrated academic health system. The affiliation aims to improve the health of the community, region, and state through research, medical education, and expanded clinical care. Renown physicians participate as joint faculty at UNR Med for teaching, lectures, supervising clinical rotations, and other academic activities for the education of medical and physician assistant students, residents and fellows.