Job Title: Contract Negotiation Specialist
Reports to: Credentialing Director
Position Overview:
The Contract Negotiation Specialist is responsible for negotiating and managing contractual agreements with insurance companies, healthcare networks, and other third-party payers. This role requires a comprehensive understanding of healthcare contracts and reimbursement structures to secure optimal terms and rates for BilliMD's providers. The Contract Negotiation Specialist will work closely with the Credentialing and Billing teams to ensure that all contract agreements align with regulatory requirements and support BilliMD’s strategic objectives.
Key Responsibilities:
Contract Negotiation: Initiate, negotiate, and finalize contracts with insurance payers, healthcare networks, and other entities, focusing on favorable terms for reimbursement and service agreements.
Rate Analysis and Benchmarking: Conduct thorough analysis of proposed rates and terms, comparing them against industry standards to identify areas for improvement.
Provider Enrollment Support: Assist in the enrollment process for new providers, ensuring contract terms align with credentialing requirements and supporting seamless onboarding.
Relationship Management: Build and maintain strong relationships with insurance representatives and payer contacts to facilitate ongoing negotiation efforts and contract renewals.
Terms and Compliance Management: Review and interpret contract language, ensuring compliance with all regulatory and legal requirements, and minimizing risks for BilliMD.
Data Analysis and Reporting: Monitor contract performance, reimbursement trends, and payer compliance, preparing reports to inform leadership of key insights and opportunities for renegotiation.
Collaboration with Internal Teams: Work closely with the Credentialing, Billing, and Operations teams to ensure cohesive contract implementation and address any issues that arise post-signing.
Issue Resolution: Address and resolve any discrepancies or conflicts in contract terms, reimbursement disputes, or other payer-related issues.
Renewals and Amendments: Track contract expiration dates and initiate timely renegotiation or amendments to maintain continuous and favorable payer relationships.
Qualifications:
Experience: Minimum of 3 years of experience in healthcare contract negotiation, reimbursement, or a related field.
Education: Bachelor’s degree in healthcare administration, business, or a related field preferred.
Skills:
Strong negotiation and communication skills with a proven record in contract negotiation.
Analytical skills with proficiency in data analysis and interpretation.
Ability to understand complex contract language and healthcare regulatory standards.
Detail-oriented with excellent organizational skills.
Knowledge: In-depth knowledge of healthcare contracting, reimbursement methodologies, and payer networks.
Job Type: Full-time
Pay: $55,487- $62,563 per year
Schedule:
Experience:
- Negotiation: 4 years (Preferred)
Ability to Commute:
- Doral, FL 33122 (Required)
Ability to Relocate:
- Doral, FL 33122: Relocate before starting work (Required)
Work Location: In person
