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Single Case Agreement information

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$12

$19

$25

How much do single case agreement jobs pay per hour?

As of Jun 9, 2026, the average hourly pay for single case agreement in the United States is $19.12, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $21.63 per hour, depending on experience, location, and employer.

What are some common challenges faced when managing Single Case Agreements (SCAs) in a healthcare setting?

Professionals working with Single Case Agreements often encounter challenges such as navigating varying payer requirements, negotiating rates, and ensuring timely communication between providers and insurance companies. Each SCA can involve complex documentation and unique approval processes, which require attention to detail and strong organizational skills. Additionally, maintaining up-to-date knowledge of insurance policies and building positive relationships with all stakeholders are crucial for successfully managing these agreements.

What is the difference between Single Case Agreement vs Physical Therapist?

AspectSingle Case AgreementPhysical Therapist
CredentialsTypically requires licensing and sometimes specific insurance or payer approvalsRequires a state license and often a Doctor of Physical Therapy (DPT) degree
Work EnvironmentUsed in healthcare settings for individual patient coverageWorks in clinics, hospitals, or outpatient centers
Employer & Industry UsageCommonly used by healthcare providers and insurance companies for specific patient casesEmployed by healthcare facilities or private practices
Comparison IntentFocuses on insurance and payer arrangements for individual casesFocuses on patient care and therapy services

Single Case Agreement is a contractual arrangement between a healthcare provider and an insurer for a specific patient, while a Physical Therapist is a licensed healthcare professional providing therapy services. The agreement pertains to insurance coverage, whereas the therapist's role involves patient treatment.

What are the key skills and qualifications needed to thrive as a Single Case Agreement (SCA) Specialist, and why are they important?

To thrive as a Single Case Agreement (SCA) Specialist, you need a strong understanding of healthcare insurance processes, contract negotiation, and medical terminology, often supported by a background in health administration or a related field. Familiarity with systems like electronic health records (EHRs), payer portals, and claims management software is typically required. Excellent communication, attention to detail, and problem-solving skills help facilitate negotiations and ensure accurate documentation. These competencies are vital to securing coverage for out-of-network services and ensuring timely patient access to necessary care.

What is a Single Case Agreement?

A Single Case Agreement (SCA) is a contract between a healthcare provider and an insurance company that allows a patient to receive services from an out-of-network provider at in-network rates, typically when there are no suitable in-network providers available. SCAs are commonly used in mental health and specialized medical care. They require negotiation between the provider and the insurer, and approval is based on the patient’s unique needs. This arrangement ensures the patient receives necessary care without facing prohibitively high out-of-network costs.
Infographic showing various Single Case Agreement job openings in the United States as of June 2026, with employment types broken down into 84% Full Time, 12% Part Time, and 4% Contract. Highlights an 81% In-person, 4% Hybrid, and 15% Remote job distribution, with an average salary of $39,767 per year, or $19.1 per hour.
Provider Network Operations Analyst Sr

Provider Network Operations Analyst Sr

AmeriHealth Caritas Health Plan

Manchester, NH • On-site

Full-time

Posted 7 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 69 frontline employees who took The Breakroom Quiz

87th of 260 rated insurance

Job description

Role Overview: The Senior Provider Network Operations Analyst responsible for maintaining current provider data and provider reimbursement setup, and to address provider and state inquiries as they relate to claim payment issues.
Work Arrangement:
  • Hybrid - The associate must be in the office at least three (3) days per week at our Manchester, New Hampshire (NH) location.

Responsibilities:
  • Review/approves and audits Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries
  • User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production
  • Facets claims edit configuration concentration (Appian) - intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and claims post-production
  • Encounter error reconciliation representation, oversight and management - including identification and initiation of claim or provider changes necessary to mitigate/prevent future errors
  • Management and resolution of state complaints
  • State policy and contract amendment changes analysis and management
  • Internal or vendor medical policy or Health Value Optimization (HVO) edit changes and initiatives
  • Monitor and review state communications and changes, lead initial analysis/determination of action, provide direction on work request submissions to level I analysts, and test/audit subsequent changes
  • Business Process Outsourcing (BPO) and/or other intake/workflow tool management
  • Single-case agreement management/ownership, including letter development and coordination with Provider Network Management (PNM)
  • Serves as the subject matter expert in State specific health reimbursement rules and provider billing requirements and as liaison to the Enterprise Operations Configuration Department
  • Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy and operational procedures to effectively provide technical expertise and business rules
  • Acts as the resource to other departments by developing and managing work plans which document the status of key relationship issues and action items for high profile providers
  • Performs other related duties and projects as assigned

Education & Experience:
  • Associate's degree preferred, or equivalent combination of education and experience in a healthcare field.
  • American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
  • 3 to 5 years of claims analysis experience in healthcare, managed care, or Medicaid environment preferred.
  • Strong working knowledge of Microsoft Excel, Access, Word, and other MS Office tools; ability to work with pivot charts, Access databases, and data analytics.
  • Claims processing and provider data maintenance knowledge required
  • Understanding of and experience related to healthcare claims payment configuration process/systems and its relevance/impact on network operations required

Skills & Abilities:
  • Ability to focus on technology and business issues, as well as communicate appropriately with both technology and business experts
  • Superior organizational skills required
  • Critical thinking skills
  • Strong customer service skills
  • Data and reporting analysis

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