Responsible for the implementation and ongoing maintenance of payer contracts, including reporting and assessment of financial performance. Completes in depth cost analysis and develops reimbursement models. Negotiates contracts, provides detailed reporting and serves as an expert and resource regarding payer specific policies and procedures, rules, and guidelines. Assists internal departments with resolution of contract issues and payment disputes through research and collaboration with payer representatives.

Education and Training

• Bachelor’s degree in healthcare administration, economics, or finance required.

 Experience

• Two to four years experience in health care/insurance contract management, billing, or finance.

 Other Skills, Competencies and Qualifications

• Familiarity with finance and reimbursement aspects of hospital and/or professional clinics required.


• Knowledge of CPT, ICD-9, ICD-10 and modifiers, medical terminology required.


• Knowledge of third party payer contract language and claim payment methodologies.


• Understanding of Medicare and Medicaid fee schedules and claim payment methodologies.


• Knowledge of computer applications including Microsoft Office products Excel and Access required.


• Excellent communication skills required.

See job description