Contracts and Payer Relations Specialist
About The Position
Easterseals PORT Health is seeking a full-time Contracts and Payer Relations Specialist to join its Contracts and Payer Relations Team in Raleigh, North Carolina. The team provides operational support for the organization’s contract portfolio, payer relations, contract implementation, reimbursement research, reporting, and contract management systems. The specialist supports the Contract & Payer Relations Manager in maintaining efficient contract operations, facilitating payer implementation activities, and supporting organizational growth initiatives. The position is mostly remote in North Carolina, with intermittent travel to the organization’s offices in the state. The employee must reside within a commutable distance of one of the office locations. The schedule is Monday through Friday, 8 a.m. to 5 p.m. Pay is $26.44–$31.25 per hour, based on experience; the position is non-exempt and eligible for overtime.
Requirements
- Associate’s degree in Business Administration, Healthcare Administration, Legal Studies, or a related field, or an equivalent combination of education and experience.
- Three years of experience in healthcare contracting, contract administration, payer relations, revenue cycle, healthcare operations, or related functions.
- Knowledge of healthcare contracts, payer structures, and reimbursement methodologies.
- Strong analytical and problem-solving skills.
- Ability to interpret contractual and operational information.
- Excellent verbal and written communication skills.
- Strong organizational and project management abilities.
- Ability to prioritize work and manage competing deadlines.
- Proficiency in Microsoft Office Suite, including Excel, Outlook, Word, SharePoint, and Teams.
- Ability to maintain confidentiality and exercise professional judgment.
- Valid North Carolina driver’s license and valid insurance for intermittent travel.
Nice To Haves
- Bachelor’s degree in Business Administration, Healthcare Administration, Legal Studies, or a related field.
- Experience with healthcare contracting and managed care organizations.
- Experience with contract lifecycle management systems.
- Experience supporting healthcare technology implementations.
- Experience in Behavioral Health, Intellectual and Developmental Disabilities (I/DD), and Substance Use Disorder (SUD) services.
Responsibilities
- Maintain and organize contract records, electronic files, databases, and supporting documentation.
- Track contract renewals, amendments, notice periods, effective dates, and implementation requirements.
- Coordinate contract routing, execution, and approval workflows.
- Maintain contract tracking tools and contract lifecycle management systems, including supporting implementation and ongoing administration of Contract Solutions.
- Prepare contract summaries, reports, dashboards, and other management reporting tools.
- Monitor payer communications, policy updates, reimbursement changes, and operational notices.
- Support routine payer communications and issue resolution activities under the direction of the Contract & Payer Relations Manager.
- Research contract provisions and gather supporting documentation for management review, contract negotiations, and implementation activities.
- Assist with resolving reimbursement and contract implementation issues.
- Maintain reimbursement documentation and contract-related records, including distributing executed contracts, amendments, and rate updates to appropriate internal stakeholders.
- Coordinate communication of contract changes and reimbursement updates to impacted departments.
- Collaborate with Operations, Revenue Cycle, Finance, Compliance, Credentialing, Quality Management, and program leadership to support contract administration activities.
- Participate in EHR implementation activities related to contract documentation, operational readiness, workflow development, and coordination with internal stakeholders.
- Assist with audits, compliance reviews, and departmental projects.
Benefits
- Generous paid time off and holidays
- Medical, dental, and vision coverage plus FSA
- Life and disability insurance
- 403(b) retirement plan
- Employee Assistance Program and legal services
- Professional development and training opportunities, including AHEC where applicable
- Public Service Loan Forgiveness (PSLF) eligibility where applicable
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
