Are you looking for an exciting opportunity?
We currently have a full-time opening for a Remote Payor Contracts Administrator. If you are looking for a fast-paced environment where you can make a difference every day, then this is the opportunity for you!
The right person to join our team is...
This position requires confidence, independent action, initiative, a sense of urgency, and the ability to make decisions and take responsibility for them. A well-suited candidate can react and adjust quickly to changing conditions and develop practical ideas for dealing with them. The style is purposeful, directed at getting things done quickly. There is a strong demand for high-quality, organized, and repeatable results.
This position is responsible for...
The Payor Contracts Administrator is responsible for reviewing, revising, and analyzing payor contracts. S/he will
implement systems and use software designed to ensure accurate tracking and recordkeeping regarding the fulfillment of
contractual obligations. The Payor Contracts Administrator serves as the Subject Matter Expert in Payor Contracts
Administration using knowledge of the regulations governing payor contracts. This position supports the Payor Contracts
leadership as required, including the creation of payment and usage history reports for either insurance, doctor, DME
contractor and/or patient payor accounts.
Your day will be very busy… you will:
- Maintains and validates the Insurance Payor Databases.
- Initiates requests to contract. Reviews contract language and pricing requests for approval by the Director,
Payor Contracts. Assists with appropriate changes to proposals and/or contracts as directed.
- Reviews Insurance Contracts to preclude inconsistencies in pricing, claim submission, medical policies and
reimbursement procedures, etc. as set forth in the payor provider manuals.
- Completes credentialing applications and provides supporting documentation to maintain and/or secure the
payor contract or enrollment with a State agency.
- Works with sensitive and confidential material that represent an immediate and possibly long-standing financial
impact on the company.
- Ensures that all claims submission guidelines including preauthorization requirements, timely filing/appeal limits
and terms and conditions are uploaded and/or implemented into the appropriate databases.
- Maintains the standard insurance database information for current listings or additions as requests are received.
- Reviews updated in-house insurance reports to:
- Verify that the billing information on the reports is correctly stated in the database.
- Validate pricing (contracted or non-contracted) and ensure that the listing is accurate within the payor
database.
- Maintain thorough communication with on-shore and off-shore billing teams for all questions
concerning the payor database.
- Supports the Central Billing Office with claims processing set-ups including EDI, EFT and ERN, answers
questions on website portals and assists with billing projects as assigned.
What your background will be:
- Bachelor’s degree preferred and 2+ years’ experience processing payor contracts and agreements.
- Familiarity with Healthcare reimbursement regulations.
- Computer proficient to include web browser/internet search, MS Outlook, MS Office to include Advanced Excel skills and the ability to produce presentation-ready slides in PowerPoint. Technical competence includes the ability to learn new software and systems.
What we can offer you...
Our insurance benefits are effective the 1st of the month after your hire date.
- Medical/Dental/Vision/Disability plans
- Paid time off (PTO)
- Company paid Holiday Pay
- Company paid Basic Life Insurance
For more information regarding Company benefits, please see https://www.breg.com/benefits
Salary/Pay Range: $53,600-$77,800 annually, plus bonus eligibility
This range reflects the minimum and maximum target range for new hire base salary/pay across all US locations. Actual pay is based on many factors unique to each candidate, including but not limited to geographical location, work experience, skill set, relevant trainings and certifications, and business needs. The base pay range is subject to change and may be modified in the future.
For six consecutive years, Breg was awarded The National Business Research Institute (NBRI) circle of Excellence Award for employee engagement.
If you meet the requirements above and would like to apply for this position, please visit our website at www.breg.com and click on the ‘Careers’ section.
Breg is an Equal Employment Opportunity Employer and dedicated to a diverse work force and Drug Free work environment. EOE/Minorities/Females/Vet/Disabled are encouraged to apply.
Applicants must be currently authorized to work in the United States on a full-time basis. The company will not sponsor applicants for a work visa for this position.
