Insurance Contracting Specialist (Hybrid)

Discovery Behavioral Health • Irvine, CA

15d • $24 - $26 • Hybrid

About The Position

Discovery Behavioral Health (DBH) is a national leader in behavioral healthcare and one of the fastest growing companies in the field. DBH offers world-class treatment for those struggling with eating disorders, mental health, and substance use and places a high priority on seeking employees who share our passion for improving the lives we serve.
Since 1997, Discovery Behavioral Health has helped thousands of patients discover their path to the full and rewarding lives they deserve with evidence-based and inclusive treatment options.
Position Summary
The Insurance Contracting Specialist reports to the Assistant Vice President (AVP) of Payer Relations and Strategy and is a key member of the Insurance Contracting Department. This role is responsible for engaging with healthcare providers and multi-specialty groups within the behavioral healthcare continuum (including eating disorder, mental health and substance use disorder services) in accordance with corporate guidelines to secure Single Case Agreements (SCAs), insurance contracts, and provider credentialing. The Specialist supports organizational access and reimbursement objectives by building provider relationships and ensuring timely, compliant contracting outcomes specific to behavioral healthcare services and levels of care.

Requirements

• High School Diploma or GED required
• Comfort and confidence in making outbound calls to potential new healthcare providers
• Required: Working knowledge of the Behavioral Healthcare industry, including mental health and substance use disorder treatment settings, levels of care, and common reimbursement structures
• Healthcare industry knowledge or experience preferred, including one or more of the following: Insurance claims and benefits for behavioral health services Provider contracting and credentialing Electronic Medical Record (EMR) systems (e.g., KIPU) CRM or enterprise systems (e.g., Salesforce, SAP) Contract negotiation or reimbursement methodologies

Nice To Haves

• Preferred experience in behavioral healthcare operations, contracting, utilization management, admissions, or payer relations

Responsibilities

• Initiate and manage time-sensitive, one-time payment agreements (Single Case Agreements) for behavioral healthcare services to meet required turnaround times and patient access needs.
• Communicate effectively and professionally with all internal and external stakeholders involved in SCA, insurance contracting, and credentialing processes related to behavioral health providers and facilities.
• Research and analyze the behavioral healthcare market, including provider types, levels of care, and regional access gaps, to identify and engage providers for potential partnerships, beginning with SCAs and/or payer contracts.
• Secure SCAs, insurance contracts, and provider credentialing in compliance with company templates, reimbursement standards, and established process controls specific to behavioral healthcare reimbursement and regulatory requirements.
• Establish, develop, and maintain strong, collaborative business relationships with behavioral health providers, facilities, and multi-specialty groups.
• Provide clear explanations and interpretations related to behavioral healthcare contracting, reimbursement methodologies, and credentialing standards within area of expertise.
• Utilize relevant data and information to identify issues, evaluate options, and resolve problems within scope of responsibility.
• Effectively prioritize, organize, and manage workload to meet strict deadlines in a fast-paced environment.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED