Contract Configuration Specialist

Job Summary

Working remotely on a full-time hourly basis, the Contract Configuration Specialist will implement and manage provider direct contracts, including loading and testing contracts in the claims system, auditing contract setups, and handling claims pricing inquiries.

Key responsibilities

• Load and test new or amended provider direct contracts across existing claims processing systems
• Audit and maintain the setup of direct contracts and fee schedules, ensuring compliance with contract language
• Field requests and inquiries from providers, clients, and vendors, collaborating cross-functionally to resolve issues

Required qualifications

• High School Diploma or GED; College Degree preferred
• Experience in a managed care or healthcare environment
• Extensive professional provider and/or facility reimbursement experience
• Experience with contract loading systems and creating fee schedules
• Familiarity with Medicare and Commercial reimbursement methodologies