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Location

Lucknow | India

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Job description

ClinicMind, the nation's leader in multi-specialty Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services, seeks a Payer Relations Specialist. If you're excited to be part of a winning team, ClinicMind is a perfect place to get ahead.

Job Summary: The Payer Relations Specialist negotiates contracts between healthcare facilities or providers and insurance companies or payers. The Payer Relations Specialist develops strategic plans to manage their accounts effectively and to expand into new accounts as assigned.

Key Responsibilities

• Works with payers to coordinate timeline for contract renewals, fee schedule updates, rate rebasing
• Organizes contract issues logs for the clinically integrated network
• Meets routinely with payers and health plans to resolve contracting/claims issues
• Maintains continuous communication to keep practices apprised of issue status and resolution
• Analyzes contract rates to ensure a competitive position in support of defensible pricing under transparency
• Provides financial analytical support by analyzing per member per month management fees, quality and shared savings incentives, and other reimbursement
• Supports contract negotiation efforts by revenue modeling & rate evaluation
• Works with payers and providers to define appropriate CPT codes and reimbursement rates for existing and new services

Qualifications

• Bachelor's degree in any STEM domain
• At least five years of experience as a Payer Relations Specialist or Provider Contract Negotiator

Must Have

• High comfort level working on Eastern Time Zone/US Shift
• Good internet access at home at least 25 MBPS
• Mobile Hotspot
• Laptop/Desktop of at least 16 GB

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Job tags

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Salary