We are seeking a Provider & Contract Configuration Specialist to support the accurate configuration, testing, and maintenance of provider contracts and fee schedules within Capital Health Plan's core operating systems. This role plays a critical part in ensuring accurate claims adjudication through precise system set-up, testing, implementation, and documentation of provider contracts, code sets, and reimbursement methodologies.
The Provider & Contract Configuration Specialist works closely with Claims, IT, Contract Administration, and Medical Leadership to troubleshoot pended claims, resolve provider disputes, and support system enhancements. This position also participates in testing efforts, analytical projects, and cross-functional initiatives to improve operational accuracy, efficiency, and compliance.
We're looking for someone who has:
Highly preferred candidates also have:
About Capital Health Plan (CHP):
CHP is a locally based, not-for-profit health maintenance organization serving the Tallahassee region for more than four decades. Founded by community leaders with a mission to deliver high-quality, affordable, and patient-centered health care, CHP has grown into a nationally recognized healthcare organization while remaining deeply rooted in the communities it serves.
CHP is proud to be an Equal Opportunity Employer and is committed to maintaining a workplace that values professionalism, integrity, and respect. We provide equal employment opportunities to all employees and applicants and do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status.
Provider & Contract Configuration Specialist • Tallahassee, FL, United States
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