[Remote] Payer Strategy & Contracting Specialist

Note: The job is a remote job and is open to candidates in USA. Ventra Health is a leading business solutions provider for facility-based physicians. The Payer Strategy & Contracting Specialist is responsible for supporting payer contract development, analysis, and strategy execution to ensure optimal reimbursement and compliance with payer requirements. Responsibilities • Conduct contract negotiation discussions on behalf of clients with payers • Assist in reviewing, interpreting, and maintaining payer contracts and fee schedules • Support negotiation preparation by compiling rate comparisons and reimbursement trends • Identify and escalate contract discrepancies impacting payment performance • Collaborate with finance and AR teams to ensure payer terms are accurately reflected in billing systems • Maintain payer-related documentation, amendments, and communication logs • Provide input for payer performance reviews and support audits as needed • Participate in payer meetings or calls to support strategic initiatives Skills • High School Diploma or GED • Strong understanding of payer contracts, reimbursement methodologies, and healthcare compliance • Familiarity with commercial and government payers in the US healthcare system • Proficiency with Excel, payer portals, and contract management databases • Become proficient in the use of billing software within 4 weeks and maintain proficiency • Ability to read, understand and apply state/federal laws, regulations, and policies • Ability to communicate with diverse personalities in a tactful, mature, and professional manner • Ability to remain flexible and work within a collaborative and fast-paced environment • Basic use of a computer, telephone, internet, copier, fax, and scanner • Basic touch 10 key skills • Basic Math skills • Understand and comply with company policies and procedures • Strong oral, written, and interpersonal communication skills • Strong time management and organizational skills • Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills • At least two to four (2-4) years of medical billing and claims resolution experience preferred • AAHAM and/or HFMA certification preferred • Experience with offshore engagement and collaboration desired Benefits • Ventra performance-based incentive plan • Referral Bonus • Discretionary incentive bonus in accordance with company policies Company Overview • “Ventra Health is a revenue cycle management organization serving hospital-based provider. It was founded in 2021, and is headquartered in Dallas, Texas, USA, with a workforce of 1001-5000 employees. Its website is https://ventrahealth.com. Apply Now Apply Now