Payer Contracting Specialist

🕒 Setembro 23

🌲 North Carolina – Remoto

🌲 North Carolina – Remote

💵 $55.000 - $65.000 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

🚫👨‍🎓 Sem graduação necessária

👻 Score fantasma 20%

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Allara

SiteLinkedInTodas as Vagas

11 - 50 funcionários

Fundada em 2020

💼 Consultoria

🛡️ Seguros

🏥 Saúde

💰 $26.000.000 Series B - Allara em 2025-01

Consulting • Insurance • Healthcare

<Allara> Allara é uma plataforma de telemedicina especializada em cuidados femininos que oferece atendimento médico e nutricional personalizado e em equipe para condições hormonais, metabólicas e ginecológicas complexas. Por meio de consultas virtuais, ginecologistas-obstetras, endocrinologistas, enfermeiros especialistas, nutricionistas e concierges de atendimento, todos com certificação profissional, a Allara oferece testes abrangentes, planos de tratamento individualizados e monitoramento contínuo, com opções de pagamento por meio de seguro ou particular.

Descrição

• Own provider data integrity across every system • Audit provider listings in payer directories and pursue corrections • Reconcile provider rosters against payer records on a recurring schedule • Serve as the point person for enrollment and provider-data escalations • Partner with Revenue Cycle to triage denials and identify root causes • Research and interpret payer policy, including medical policy bulletins, telehealth and virtual care rules, prior authorization requirements, fee schedules, and provider manuals • Locate and maintain executed agreements, amendments, rosters, W9s, and welcome letters • Document payer requirements and resolved escalations in durable internal references • Support contracting and credentialing by preparing, submitting, and tracking payer applications for new health plan partnerships and service lines • Provide surge support for follow-up, deficiency resolution, revalidations, and trackers

🎯 Requisitos

• 2+ years in provider data management, revenue cycle, denials, payer operations, credentialing, or healthcare administration; internship or adjacent RCM experience counts • Genuinely self-directed • Enjoy researching and finding payer policies and requirements • Root-cause analysis mindset • Exceptional attention to detail • Comfortable on the phone with payers • Strong with spreadsheets and quick to learn new systems and payer portals • Comfortable with ambiguity and shifting priorities in a fast-paced, remote-first environment • Able to document solutions and processes • Hands-on experience with payer portals and clearinghouses such as Availity is preferred • Experience with provider directory accuracy, roster submissions, or demographic data management is preferred • Denial management or AR follow-up experience is preferred • Familiarity with commercial payer requirements; Medicare and Medicaid exposure is a plus • Multi-state telehealth, digital health, or high-growth healthcare experience is preferred • Exposure to credentialing standards such as NCQA and CMS is preferred • Working familiarity with CPT/ICD-10 and modifiers; no certification required

🏖️ Benefícios

• Equity • Professional development and employee learning programs • Comprehensive health benefits (medical, dental, vision) • Generous paid time off • Additional wellness and professional development perks • 100% remote within the U.S. • Unlimited PTO • 11 company holidays • Health Savings Account (HSA) • Flexible Spending Account (FSA) • Long- and short-term disability coverage • Annual employee wellness stipend • 401(k) plan • Parental leave • Family planning support benefits • Company-issued laptop • Annual work-from-home stipend • Commuter benefits (if applicable) • Opportunities for advancement • Collaborative, mission-driven culture focused on improving patient care