Payer Contracting Specialist
New
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AllaraWomen's Health
Fully remote within the U.S.Full-TimeEntry
Salary$55,000 - $65,000
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Job Details
- Experience
- 2+ years
Requirements
- 2+ years of experience in provider data management, revenue cycle, denials, payer operations, credentialing, or healthcare administration.
- Proven ability to manage individual tasks and queues independently.
- Exceptional attention to detail regarding sensitive data like Tax IDs, taxonomies, and effective dates.
- Strong proficiency with spreadsheets and aptitude for learning new software systems and payer portals.
- Polite and persistent professional communication skills, especially for phone interactions with payers.
- Ability to work effectively in a fast-paced, remote-first environment with shifting priorities.
- Commitment to documenting processes and maintaining internal reference materials.
- Demonstrated ability to identify root causes of administrative issues rather than applying temporary fixes.
- Experience with payer portals and clearinghouses is preferred.
- Knowledge of credentialing standards (NCQA, CMS) is a plus.
- Familiarity with medical coding terminology such as CPT, ICD-10, and modifiers is preferred.
Responsibilities
- Maintain provider data integrity across all internal systems and ensure consistency in payer records.
- Audit provider appearances in payer directories and drive corrections to improve search accuracy for members.
- Reconcile provider rosters against payer records on a scheduled basis to proactively identify discrepancies.
- Act as the primary point of contact for enrollment and provider-data escalations.
- Collaborate with the Revenue Cycle team to investigate, triage, and address root causes of claim denials.
- Interpret and research payer policies, including telehealth rules, fee schedules, and prior authorization requirements.
- Develop and maintain internal documentation for payer requirements to improve operational knowledge sharing.
- Support contracting and credentialing by managing applications, deficiency resolution, and tracking for new health plan partnerships.
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