СШАPayer Contracting Specialist
3 нед. назад
СШАRemote
contract managementdata managementpayer relations
Responsible for accelerating payer contracting efforts to expand access to women's health services.
Обязанности
- We're looking for a resourceful Payer Contracting Specialist to accelerate our payer contracting efforts. This role will be a critical driver of expanding women’s access to Allara’s services across the country.
- Being in-network on paper isn't the same as working in practice. Each new payer has its own written and unwritten requirements. You'll figure out what each new payer actually requires, how we need to work with them, and write it down so we never experience an issue we don’t need to. You'll run escalations to the root cause, and work with our teams to figure out solutions quickly. You'll keep our provider data clean so that applications are right before they go out the door, not after a payer sends them back.
- That's this job. You'll be the person who finds the discrepancy, fixes it at the source, works the payer until it sticks, and writes down how you did it so nobody has to figure it out twice.
- This is an early-career position with unusual breadth, but requires minimal experience and expertise. You'll touch provider data, payer policy, contracting, revenue cycle, and credentialing, which makes it one of the fastest ways to learn how healthcare payment actually works. There's a clear path into more complex payer relationships and ownership over time.
- Location: Fully remote within the U.S.
- Own provider data integrity across every system. Keep all payer records consistent, correct, and current.
- Audit how our providers appear in payer directories and chase corrections until they're live and members can actually find them.
- Reconcile rosters against payer records on a recurring audit schedule, so discrepancies surface on a cadence rather than when a claim is denied.
- Be the go-to desk for enrollment and provider-data escalations. Partner with Revenue Cycle to triage denials and figure out root causes.
- Research and interpret payer policy: medical policy bulletins, telehealth and virtual care rules, prior authorization requirements, fee schedules, and provider manuals. Find the documents nobody can find such as executed agreements, amendments, rosters, W9s, welcome letters.
- Codify what you learn. Turn each new payer's requirements and each resolved escalation into a durable internal reference so the next person doesn't start from zero.
- Support contracting and credentialing: prepare, submit, and track payer applications for new health plan partnerships and service lines; provide surge support on follow-up, deficiency resolution, revalidations, and trackers.
Требования
- We care much more about how you work than what's on your resume.
- 2+ years in provider data management, revenue cycle, denials, payer operations, credentialing, or healthcare administration. Internship or adjacent RCM experience counts
- Genuinely self-directed. You manage your own queue without reminders, follow up without being asked, and treat a stalled item as a personal affront
- You enjoy the hunt. Being told "the policy is somewhere on their site" is interesting to you, not annoying
- You think about root causes. Fixing the claim is table stakes; understanding why it denied and stopping the next twenty is the job
- Exceptional attention to detail. Wrong TIN, wrong taxonomy, wrong effective date - these are the difference between getting paid and not
- Comfortable on the phone with payers. A lot of this job is being politely persistent with someone who'd rather not help
- 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
- You write things down. Solving a problem once is good; documenting it so the team never re-solves it is better
Будет плюсом
- Hands-on experience with payer portals and clearinghouses (Availity, plan-specific portals)
- Experience with provider directory accuracy, roster submissions, or demographic data management
- Denial management or AR follow-up experience, especially enrollment- and credentialing-related denials
- Familiarity with commercial payer requirements; Medicare and Medicaid exposure is a plus
- Multi-state telehealth, digital health, or high-growth healthcare experience
- Exposure to credentialing standards (NCQA, CMS)
- Working familiarity with CPT/ICD-10 and modifiers - no certification required
Условия
- Compensation & Career Growth $55,000 - $65,000 with opportunities for advancement
- Equity
- Professional development & employee learning programs
- Actual compensation will be determined based on a variety of factors, including but not limited to: candidate experience, location, education, certifications, and skill set. In addition to base salary, our total compensation package includes equity, comprehensive health benefits (medical, dental, vision), generous paid time off, and additional wellness and professional development perks.
- Work Environment & Flexibility 100% remote within the U.S.
- Unlimited PTO & 11 company holidays
- Health & Wellness Medical, dental, and vision benefits
- Health Savings Account (HSA) & Flexible Spending Account (FSA)
- Long- and short-term disability coverage
- Annual employee wellness stipend
- Family & Future Planning 401(k) plan
- Parental leave & family planning support benefits
- Additional Perks Company-issued laptop
- Annual work-from-home stipend
- Commuter benefits (if applicable)
- A collaborative, mission-driven culture focused on improving patient care
Другое
- Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Trusted by over 60,000 women nationwide, Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams that have a deep understanding of hormonal, metabolic, and reproductive care. Allara provides ongoing support for hormonal conditions like PCOS, chronic conditions like insulin resistance, and life stages like perimenopause, helping patients see improved health outcomes . As one of the fastest-growing women’s health platforms in the U.S., Allara is bridging long-overlooked gaps in healthcare for women.