Payer Relations Specialist

Essential Responsibilities:

• Maintain and Update Payer Contract Rates – Regularly review, validate, and input payer contract rates into billing systems to ensure they reflect current negotiated agreements, fee schedules, and reimbursement terms; flag discrepancies between contracts and system data for immediate correction
• Audit Billing System Accuracy – Conduct periodic audits and reconciliation of contract rates loaded in the billing system against source contract documents; identify and resolve gaps or errors that could impact claim reimbursement or revenue recognition
• Document and Track Contract Changes – Maintain comprehensive documentation of all payer contracts, amendments, and rate modifications; track implementation dates and create a centralized repository for contract versions to ensure billing staff reference current rates
• Collaborate with Revenue Cycle Team – Work closely with billing, coding, and accounts receivable teams to communicate rate changes, policy updates, and any systems modifications that affect claims processing or payment posting

Education and Knowledge:

• Bachelor's degree in Business, Healthcare Administration or related field
• Demonstrated ability to use PCs, Microsoft Office suites with advanced Excel capabilities
• 3+ years of experience in healthcare patient access, financial clearance or revenue cycle functions