Medical Billing – Payer Strategy & Contracting Specialist
Medsuite Inc
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Responsible for supporting payer contract development, analysis, and strategy execution to ensure optimal reimbursement and compliance with payer requirements.
- Conduct contract negotiation discussions on behalf of clients with payers
- Assist in reviewing, interpreting, and maintaining payer contracts and fee schedules.
- Support negotiation preparation by compiling rate comparisons and reimbursement trends.
- Identify and escalate contract discrepancies impacting payment performance.
- Collaborate with finance and AR teams to ensure payer terms are accurately reflected in billing systems.
- Maintain payer-related documentation, amendments, and communication logs.
- Provide input for payer performance reviews and support audits as needed.
- Participate in payer meetings or calls to support strategic initiatives.
Requirements
- High School Diploma or GED
- At least two to four (2-4) years of medical billing and claims resolution experience preferred
- AAHAM and/or HFMA certification preferred
- Experience with offshore engagement and collaboration desired
- Strong understanding of payer contracts, reimbursement methodologies, and healthcare compliance.
- Familiarity with commercial and government payers in the US healthcare system.
- Proficiency with Excel, payer portals, and contract management databases.
- Become proficient in the use of billing software within 4 weeks and maintain proficiency
- Ability to read, understand and apply state/federal laws, regulations, and policies
- Ability to communicate with diverse personalities in a tactful, mature, and professional manner
- Ability to remain flexible and work within a collaborative and fast-paced environment
- Basic use of a computer, telephone, internet, copier, fax, and scanner
- Basic touch 10 key skills
- Basic Math skills
- Understand and comply with company policies and procedures
- Strong oral, written, and interpersonal communication skills
- Strong time management and organizational skills
- Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills
Benefits
- Ventra performance-based incentive plan
- Referral Bonus
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical billingclaims resolutionpayer contractsreimbursement methodologieshealthcare compliancebilling softwareExcelcontract management databasesrate comparisonsreimbursement trends
Soft Skills
communicationflexibilitycollaborationtime managementorganizational skillsinterpersonal skillstactfulnessmaturityprofessionalismability to work in fast-paced environment
Certifications
AAHAM certificationHFMA certification