Contracts Specialist

Job Summary

Handling pre-claim and out-of-network physician contract negotiations, the full-time Contracts Specialist will manage inquiries, secure agreements, and identify cost-saving opportunities while working independently in a dynamic healthcare environment.

Key responsibilities

• Handle facility, provider, and client inquiries regarding pre-claims and out-of-network physician contract requests
• Secure signed agreements for reimbursement with providers and maintain relationships with central providers
• Research claims and determine cost-saving opportunities and pricing optimization strategies

Required qualifications

• Minimum high school diploma plus two years of experience in a medical healthcare claims role
• Background in healthcare claims management, including provider hospital billing and claims adjudication
• Demonstrated negotiation experience and a proactive, self-starter attitude
• Ability to manage high call volume and multi-task effectively in a fast-paced environment
• PC literate, including proficiency in Microsoft Office products and web-based applications