Manage payor relations, review contracts, conduct negotiations, and oversee credentialing processes between the health center and insurance companies.
Contracting and Payor Relations Specialist
The primary purpose of this job is to manage payor relations between Lynn Community Health, Inc and insurance companies. This individual will review contracts, conduct analysis, negotiation, implementation, payer relations, and payor credentialing for the health center.
Responsibilities:
- Identifies, analyzes, and manages payor projects, as assigned, such as auditing contract provisions, completing credentialing requests, interdepartmental work groups, negotiations and maintenance of payor contracts and legal files.
- Understands legal terms and concepts related to contracting; Must be able to research state and federal laws and statute and interpret their meaning and use in Managed Care contracts.
- Negotiates Single Case Agreements with Payers as may be required.
- Own the credentialing process for each payor and submit all relevant information timely.
Qualifications:
- Minimum Education: HS Diploma or equivalent Required
- 2-3 years of experience.
Minimum Work Experience
- Previous experience in health care business office, contracting or payer organization Required
Lynn Community Health Center Lynn, Massachusetts, USA Office
269 Union St, Lynn, Massachusetts, United States, 01901 1314
Lynn Community Health Center Lynn, Massachusetts, USA Office
29 Market Square, 694 Western Avenue, Lynn, Massachusetts, United States, 01905
Lynn Community Health Center Lynn, Massachusetts, USA Office
20 Central Ave, Lynn, Massachusetts, United States, 01901 1201
Lynn Community Health Center Lynn, Massachusetts, USA Office
280 Union St, Lynn, Massachusetts, United States, 01901 1353
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