*100% Remote* Healthcare Contract Specialist

Contemporary Staffing Solutions is seeking a dedicated and detail-oriented Provider Operations Specialist to join our client for a remote opportunity! In this role, you will play a crucial part in operationalizing both new and existing provider contracts, ensuring accuracy and adherence to contractual terms.

Responsibilities:

• Assist in loading and testing provider contracts.
• Support setup of new contracts, fee schedules, and amendments.
• Coordinate annual contract rate updates.
• Handle claims pricing inquiries and coordinate resolutions.
• Audit contract loads for adherence.
• Review and align provider demographic data with agreements.
• Contribute to quality improvement efforts.
• Adhere to turnaround time standards.
• Understand organizational strategies.
• Provide feedback on system needs.
• Participate in system testing and improvements.
• Perform other assigned duties.

Required Experience / Education:

• Associates Degree
• Minimum of 1 year of experience
• Experience in a managed care/healthcare environment.
• Extensive Professional Provider and/or Facility reimbursement experience required.
• Experience creating fee schedules.
• Understanding of complex provider contracts.
• Knowledge of binding terms and provisions in contracts.
• Functional knowledge of payment methodology.
• Experience with contract loading systems involving interpreting and programming reimbursement methodologies.
• Strong analytical and problem-solving skills.
• Familiarity with Medicare and Commercial reimbursement methodologies.
• Strong verbal and written communication skills.