JOB DESCRIPTION:
The Contracting & Credentialing Director evaluates and negotiates contracts in compliance with company contract structure, reimbursement structure standards and other key process controls. Responsibilities also include directly negotiating contract terms with insurance payors, coordinate and manage multiple, large-scale projects related to physician contract remediation and other contracting initiatives, coordinate with internal matrix partners to support contract/relationship management, assess and interpret payor requirements, solve moderately complex problems and/or conduct moderately complex analysis, translate concepts into practice, provide explanations and information to others on difficult issues, oversee provider and practice credentialing with hospitals and payors including Medicare and Medicaid.
REQUIRED SKILLS AND KNOWLEDGE:
Individual should have an undergraduate degree or combination of education and relevant work experience. Experience utilizing financial models and analysis in negotiating rates with payors. Strong negotiation skills. Problem solving and analytical skills. Excellent verbal and written communication skills. Knowledge of physician reimbursement methodologies is a plus. Knowledge of claims processing and guidelines is helpful.
Benefits:
- 401(k)
- 401(k) matching
- AD&D insurance
- Dental insurance
- Disability insurance
- Flexible spending account
- Free parking
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
