- Analyze payor contracts to identify opportunities for negotiation and optimization of reimbursement rates.
- Negotiate contracts with payors to ensure favorable terms and conditions for the organization.
- Collaborate with internal stakeholders, including finance and operations teams, to assess contract performance and identify areas for improvement.
- Monitor changes in healthcare regulations and industry trends that may impact reimbursement rates and contract negotiations.
- Prepare financial analyses and reports to support contract negotiations and decision-making processes.
- Maintain accurate records of contract terms, negotiations, and outcomes.
- Serve as a subject matter expert on payor contracting issues and provide guidance to internal teams as needed.
- Stay informed about industry best practices and emerging trends in payor contracting and reimbursement analysis.
- Minimum of 4 years of experience in reimbursement analysis, with a focus on hospital reimbursement.
- Epic software experience
- Bachelor's degree in Healthcare Administration, Finance, Business, or related field is preferred.
- Healthcare Financial Management Association (HFMA) Billing Certification completed within one year of hire date.
- Strong understanding of healthcare finance principles and reimbursement methodologies, ICD-10, CPT, HCPCS and Epic software
- Knowledge of Commercial, Medicaid and Medi-Cal.
- Experience in negotiating contracts with healthcare payors preferred.
- Excellent analytical and problem-solving skills.
- Ability to communicate effectively and collaborate with cross-functional teams.
- Proficiency in Microsoft Excel and other financial analysis tools.
- Detail-oriented with a high level of accuracy in work output.
- Ability to work independently and prioritize tasks in a fast-paced environment.
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Payor Contracting Specialist - Placerville, United States - LHH Recruitment Solutions
Description
Job Description
Job DescriptionPayor Contracting Specialist
Epic software experience is REQUIRED
Hybrid: Placerville, CA opportunity for hybrid)
Pay range: $26 - $32 per hour (dependent on incoming experience)
Monday-Friday | 8a-5p
The Payor Contracting Specialist will be responsible for managing and negotiating contracts with payors to ensure optimal reimbursement rates for our healthcare services. This position requires a detail-oriented individual with a strong background in reimbursement analysis and hospital reimbursement practices.
The ideal candidate will have a minimum of four years of experience in reimbursement analysis, with additional experience as a financial analyst preferred.
Key Responsibilities:
Qualifications you bring:
Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.
Search managed by: Katherine Geanetta
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to
The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.
