SPECTRAFORCE · 1 week ago
Managed Care Contract Analyst
Dalton, GA
Full-time, Contract
Hybrid
Mid, Senior Level
$70K/yr - $80K/yr
3+ years expSPECTRAFORCE is seeking a Managed Care Contract Analyst to manage and analyze payer contracts. The role involves supporting contract negotiations and performance monitoring, as well as interpreting complex contract language and identifying reimbursement trends.
ConsultingCRMInformation TechnologyLegal
Hiring Manager
Saad Ullah Khan
Responsibilities
Manage and maintain payer contracts, including inventory of agreements, rate grids, and contract terms
Support contract negotiations through data extraction, analysis, and complex reimbursement modeling
Model and assess payer reimbursement performance and identify trends in payment practices
Identify and assist with revenue cycle reimbursement issues and communicate findings to stakeholders
Interpret complex administrative and financial contract language and clearly communicate impacts internally and externally
Stay current on payer billing and reimbursement changes and proactively communicate updates
Interface with outside vendors and consultants as needed
Complete credentialing and re-credentialing applications
Ensure accuracy and integrity of contract management systems and data
Qualification
Required
Bachelor's degree in Business, Accounting, Finance, or Healthcare Management
3–5+ years of healthcare managed care or payer contract management experience
Strong understanding of payer contract language and reimbursement methodologies
Hands-on experience with CPT, ICD-9, and modifiers
Hands-on experience with Hospital Medicare and Medicaid fee schedules
Hands-on experience with third-party billing requirements and claim payment methodologies
Hands-on experience with claim system requirements, procedures, and controls
Advanced proficiency in Excel; working knowledge of Word and PowerPoint
Strong analytical skills with high attention to detail
Excellent written and verbal communication skills
Experience with contract management software or strong technical aptitude to learn quickly
Company
SPECTRAFORCE
Welcome to SPECTRAFORCE, your gateway to NEWJOBPHORIA™! Established in 2004, SPECTRAFORCE is now one of the largest and fastest growing U.S.
1001-5000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase