Job Summary

A health benefit consulting company has anopenposition for a Remote Provider Contracts Operations Specialist.

Must be able to:

• Assist with loading and testing of provider contracts across existing claims processing systems
• Coordinate with Provider Engagement to track and implement annual contract rate updates
• Triage and handle any claims pricing inquiries related to contract programming

Skills and Requirements Include:

• High School Diploma or GED required
• Experience working in a managed care/ health care environment
• Extensive Professional Provider and/or Facility reimbursement experience
• Experience creating fee schedules
• Understanding of complex provider contracts
• Functional knowledge of payment methodology