Provider Contracting Specialist

A company is looking for a Provider Contracting & Negotiating Specialist.

Key Responsibilities

Initiate contact with provider offices for out-of-network services and negotiate fees and rates

Perform data entry and documentation of repricing of medical claims and oversee the claim adjudication process

Correspond with providers and liaise with clients and other departments on negotiation requests

Required Qualifications

High School Diploma or equivalent

1 year of provider contracting or data / network administration experience in a healthcare setting or 2 years of claims processing / customer service experience

Prior work experience in a production environment

Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint

Ability to maintain confidentiality and demonstrate sound judgment in decision-making