Payer Contracting Specialist
New
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AllaraWomen's Health
Fully remote within the U.S.Full-TimeEntry
Salary$55,000 - $65,000 / year
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Job Details
- Experience
- 2+ years
Requirements
- 2+ years in provider data management, revenue cycle, denials, payer operations, credentialing, or healthcare administration.
- Self-directed work style with strong queue management and follow-up skills.
- Ability to investigate and resolve root causes of issues.
- Exceptional attention to detail for handling sensitive data like TINs and taxonomy.
- Strong communication skills for interacting with payers over the phone.
- Proficiency with spreadsheets and ability to learn new systems and payer portals.
- Experience with documentation and creating process references.
- Comfort with ambiguity and fast-paced, remote-first environments.
- Hands-on experience with payer portals and clearinghouses (e.g., Availity) is preferred.
- Familiarity with commercial payer requirements, credentialing standards (NCQA, CMS), and CPT/ICD-10 coding is a plus.
Responsibilities
- Own provider data integrity across every system and keep records consistent and current.
- Audit provider appearances in payer directories and ensure accurate information for members.
- Reconcile rosters against payer records on a recurring audit schedule.
- Triage enrollment and provider-data escalations and partner with Revenue Cycle to address denials.
- Research and interpret payer policies, including telehealth rules, fee schedules, and provider manuals.
- Codify knowledge by creating durable internal references for payer requirements.
- Prepare, submit, and track payer applications and provide support on credentialing tasks.
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