Contract Specialist, Configuration

Job Summary

Working remotely, the full-time Contract Specialist, Configuration will manage the loading of Professional, Facility, and Ancillary contracts across all lines of business, ensuring accuracy and timely execution while collaborating with various teams to facilitate contract maintenance and reimbursement processes.

Key responsibilities

• Participate in provider, facility, and ancillary rate configurations, ensuring accuracy and adherence to deadlines
• Collaborate with Network Management and Analytics to capture and validate negotiated contractual agreements
• Analyze contracts to ensure reimbursement aligns with negotiated terms and coordinate updates for evergreen contracts

Required qualifications

• B.S. degree in Business Operations, Information Systems, or equivalent
• Minimum 2-3 years of relevant experience, preferably in a healthcare environment
• Strong familiarity with EmblemHealth's claims systems and interdependent applications
• Experience in provider, facility, and ancillary contract file setups, maintenance, and testing
• Excellent knowledge of medical terminology, Fee Schedules, and ICD/CPT/HCPCS coding