Payor Relations – Contracting Specialist

Carle Health

Payor contracting specialist coordinating reimbursement agreements for Carle Health, an Illinois healthcare provider. Managing payor relations, contract renewals, fee schedules, and revenue-cycle impacts.

Posted 8/10/2026full-timeRemote • Illinois • 🇺🇸 United StatesMid-LevelSenior💰 $27 - $45 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in payor contracting processes, reimbursement methodologies, and compliance with regulations. Proficient in managing relationships with payors and coordinating with various teams to ensure accurate claims submissions and contract management.

Highest-signal resume keywords

Payor Contracting ProcessesReimbursement MethodologiesEpic Revenue Cycle SystemsContract Database ManagementCompliance with Regulations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Contract ReviewClaims SubmissionProvider EnrollmentFacility RecredentialingPlan Code Mapping

Soft Skills

Relationship ManagementCollaborationProblem Solving

Tools & Technologies

Epic System

Certifications & Qualifications

Associate's Degree

Industry Keywords

Payor RelationsBilling DisputesReimbursement DiscrepanciesManaged Care Contract DatabaseFederal Regulations

About the role

Key responsibilities & impact

Coordinate payor contracting processes for Carle Foundation entities, including hospitals, ancillary services, provider groups, and ambulatory surgery centers
Develop and maintain information for monitoring and reporting payor contract rates and terms
Coordinate payor and provider contracting programs
Ensure compliance with contract terms, including renewal and termination provisions
Cultivate relationships with payors and manage payor and internal department inquiries
Research claims reviews and provider load issues
Maintain a managed care contract database and track annual renewals
Facilitate Payor Escalation meetings with Revenue Cycle Staff
Support contracts from initiation through implementation and completion
Gather administrative and clinical department input on new and amended contracts
Manage action items from monthly Payor meetings with billing, case management, and provider enrollment teams
Coordinate communication of payor changes, including Epic system and training requests
Serve as liaison and subject matter expert on contracting, payor relations, and reimbursement discrepancies
Map new plan codes and participate on the Payor Plan Code committee
Manage annual charge increases and contractual impacts
Obtain, maintain, and distribute payor fee schedules
Review contract language and payor policies to determine reimbursement for new procedures and services
Coordinate facility recredentialing data collection
Collaborate with billing, coding, and compliance teams to ensure accurate and timely claim submissions
Ensure compliance with federal, state, and local regulations and industry best practices

Requirements

What you’ll need

Associate's Degree (Required)
Experience in medical payor work
Knowledge of payor contracting processes and reimbursement methodologies
Ability to review contract language and payor policies
Ability to manage payor relations, billing disputes, and reimbursement discrepancies
Ability to maintain contract databases and track renewals
Ability to coordinate with billing, coding, compliance, clinical, and administrative teams
Knowledge of Epic revenue cycle systems and training request processes
Understanding of claims submission, provider enrollment, facility recredentialing, and plan code mapping
Ability to ensure compliance with federal, state, and local regulations

Benefits

Comp & perks

Comprehensive benefits package
Day shift
Monday–Friday schedule
No weekend requirements
No holiday requirements
No on-call requirements