Contract Management – Revenue Integrity Specialist

Nira Medical Group

Contract Management Specialist responsible for leading payer contract negotiations and managing revenue integrity. Collaborating across teams to ensure financial precision and compliance at Nira Medical.

Posted 5/27/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Lead all new payer contract negotiations, managing the end-to-end process from initial outreach through execution, ensuring terms align with organizational goals and market benchmarks.
Establish and maintain fee schedules and contracted rates for professional services, drug/pharmacy, and ancillary services. Own rate-setting decisions in collaboration with Finance and clinical leadership.
Maintain, update, and audit all payer allowable tables within Athena and any other relevant systems. Coordinate quarterly or monthly allowable schedule pulls based on payer requirements and internal cadence needs.
Identify, track, and resolve payment variances resulting from a mismatched allowable between contracted rates and actual payer remittances. Partner with billing and RCM teams to correct discrepancies and prevent recurrence.
Serve as the primary point of contact for payer inquiries and projects related to contract pricing. Facilitate timely resolution of payer-initiated issues and proactively surface risks to leadership.
Generate and distribute regular reporting on contract performance, allowable schedules, out-of-network activity, and no-go status. Ensure leadership has the visibility needed for strategic decision-making.
Conduct out-of-network analyses to evaluate financial exposure and inform contracting strategy. Maintain and distribute no-go reporting to flag payers or services where participation is not financially viable.
Manage all updates within Athena related to contracts, allowable updates, payer configurations, and rate changes. Ensure system accuracy is maintained continuously, and changes are tested and validated upon implementation.

Requirements

What you’ll need

Associate’s degree in healthcare administration, business, finance, or a related field; or equivalent relevant experience in payer contracting or revenue integrity
Minimum 3–5 years of experience in payer contracting, allowable management, or revenue integrity roles
Strong understanding of fee schedule structures, payer reimbursement methodologies, and contract terms across professional, drug/pharmacy, and ancillary service lines
Demonstrated experience managing allowable tables and rate configurations within Athena EHR or similar practice management systems
Proficiency in identifying and resolving payment variances and mismatch allowable
Experience with out-of-network analysis and no-go reporting frameworks
Excellent analytical and problem-solving skills with high attention to detail
Strong communication and negotiation skills; comfortable interfacing directly with payer representatives
Ability to manage multiple priorities and deadlines in a fast-paced, growth-oriented environment
Experience working in a multi-specialty, multi-location healthcare organization preferred
Athena EHR experience strongly preferred; experience with MSO structures a plus

Benefits

Comp & perks

Health insurance
Flexible work arrangements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

payer contractingallowable managementrevenue integrityfee schedule structurespayer reimbursement methodologiescontract termspayment variance resolutionout-of-network analysisno-go reporting frameworksrate configurations

Soft Skills

analytical skillsproblem-solving skillsattention to detailcommunication skillsnegotiation skillsability to manage multiple prioritiesability to meet deadlines

Certifications

Associate’s degree in healthcare administrationAssociate’s degree in businessAssociate’s degree in finance