Payor Contract Specialist

4 days ago


Troy, Michigan, United States HarmonyCares Full time
About the Role

We are seeking a highly skilled Payor Contract Specialist to join our team at HarmonyCares. As a key member of our organization, you will be responsible for managing and maintaining our payor contracts, ensuring seamless payment integrity and maximizing collections.

Key Responsibilities
  • Contract Management: Maintain an internal payor contract matrix, organizing contracts in an easy-to-identify fashion for all applicable departments and business lines.
  • Payment Integrity: Review new contracts, ensuring accurate payment rates and identifying over/under payments, market, business, and reimbursement trends.
  • Reporting and Analysis: Create, assemble, and communicate reports, detailed analyses, and trends needed by various internal and external customers.
  • Collaboration: Act as the main point of contact for internal questions related to securing new deals, reviewing initial contract terms, and collaborating with internal departments on business needs.
  • Contract Amendments: Review contract amendments, providing notes on changes and impacts, and coordinating the submission of all documents necessary to secure new payor contracts.
Requirements
  • Education: Associate's degree in Business or related field.
  • Experience: Experience with filling out group credentialing applications required by health plans as it relates to contract execution.
  • Skills: Strong analytical and problem-solving skills, ability to communicate with employees, management, and payer representatives, and proficiency in Excel.
Preferred Qualifications
  • Education: Bachelor's degree.
  • Experience: 3+ years of experience in a contract analyst role, with home health and hospice contracting experience.
  • Certification: Certification in payor contracting through MGMA or other association.
What We Offer

As a Payor Contract Specialist at HarmonyCares, you will have the opportunity to work with a dynamic team, contribute to the growth and success of our organization, and enjoy a competitive compensation package.



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