Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. One of the nation’s largest nonprofit Catholic healthcare organizations. Delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites, and 137 hospital-based locations. Offers home-based services and virtual care offerings. Employs more than 157,000 employees, including 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states. Contributes more than $4.2 billion annually in charity care, community benefits, and unreimbursed government programs. Creates a more just, equitable, and innovative healthcare delivery system with patients, physicians, partners, and communities.
Payer Strategy Contract Specialist
Location
United States
Posted
3 days ago
Salary
$29 - $44 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Payer Strategy Contract Specialist
Dignity Health
Role Description As our Payer Strategy Contract Specialist, you will work closely with leadership to support the negotiation of favorable terms for various agreements within the managed care landscape. Your expertise will be applied across a range of organizational entities. Every day, you will focus your efforts on ensuring that all terms and conditions of these agreements adhere to organizational standards and recognized best practices. You will meticulously align contract terms with broad operational objectives, contributing to the financial sustainability and strategic goals of the organization. To be successful in this role, you will possess a strong understanding of complex contracting, effective negotiation support skills, and meticulous attention to contractual details. Your ability to collaborate effectively with leadership, interpret intricate agreement language, and ensure compliance with internal standards will be essential in navigating payer relationships. - Supports the review of contract proposals, language and rate sheets to ensure accuracy, completeness and in compliance with CommonSpirit Health standards and guidelines. - Recommends corrections, changes and any language opportunities in documents to PSR leadership. - Assists PSR leadership with developing and updating project plan documents, meeting minutes and action item follow up related to National Payers renewals and planning. - Ensures all amendments, letters of agreement (LOA), memorandum of understanding (MOU) and other contract documents are signed by the appropriate parties and provide the fully executed contract documents to the Contract Administration team. - Ensures contract documents include rate escalators and obtain updated rate tables fee schedules and all contracting materials are stored according to PSR and/or Legal Policies, and ensures information is made available to or disseminated to key stakeholders of the negotiation process. - Coordinates with other PSR team members to facilitate credentialing and re-credentialing of CSH entities. Qualifications - Bachelors or equivalent education and experience. - Three (3) years’ contract management experience in a healthcare related field.
Related Guides
Related Categories
Related Job Pages
More Medical Billing and Coding Jobs
Inpatient Coder II
CommonSpirit HealthCommonSpirit Health is a nonprofit organization that is on a mission to improve people’s health while making “the healing presence of God known.” The orga
Title: Inpatient Coder II Job Description: Requisition ID 2026-483028 Department HIM Coding Hours / Pay Period 80 Shift Day Standard Hours Standard Hours Posted Pay Range $27.86 - $47.28 /hour Telecommute Yes Where You’ll Work With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success. This is an advanced level coding position that codes and abstracts Inpatient records for data retrieval, analysis, reimbursement and research. Codes and enters diagnostic and procedure codes into a designated coding and abstracting system utilizing the 3M encoder, as appropriate. Meets quality and productivity coding standards and demonstrates the ability to navigate an EMR. Ability to code across all facilities. Along with CO, KS and NM, this position is open to remote/out of state candidates residing in only these states: - Alabama- Arizona- Arkansas- Colorado - Florida- Georgia- Idaho- Indiana - Iowa- Kansas - Kentucky- Louisiana - Missouri- Mississippi- Nebraska- New Mexico - North Carolina- Ohio- Oklahoma- South Carolina - South Dakota- Tennessee- Texas- Utah - Virginia- West Virginia- Wyoming Job Requirements In addition to bringing humankindness to the workplace each day, qualified candidates will need the following: - High School Diploma/ GED Required - Associate Degree Preferred - A minimum of 4 years coding experience preferably in an inpatient acute care setting or a minimum of 2 years' experience and successful completion of the organizations internal coding program. - Current AHIMA credentials (i.e. RHIA, RHIT, CCS, CCS-P) or AAPC credentials (COC, CIC, CPC-H, CPC), required or must be certified within One Year of hire. - Must demonstrate competency of inpatient coding guidelines and DRG assignment. - Basic knowledge of Microsoft Office applications and emails and troubleshooting computer problems. - Experience successfully working in a remote environment, preferred - Demonstrate intermediate to advanced technical coding competency in ICD-10 CM, CPT-4, HCPCS and Coding Modifiers - Knowledge of disease management, anatomy and physiology, medical terminology, pharmacology and coding systems (i.e.3M)
Role Description The Accounts Receivable Specialist plays a critical role in supporting the financial health of the organization by managing and following up on outstanding balances. This position is responsible for: - Maintaining and updating the daily collections spreadsheet - Ensuring timely follow-up on outstanding accounts throughout the day - Serving as a key resource within the Revenue Cycle department The ideal candidate will bring strong attention to detail, persistence, and excellent communication skills to help drive effective collections and support overall revenue operations. Responsibilities - Resolve patient account balances associated with insurance denial - Answer incoming insurance and practice calls as needed - Explain charges, services, and insurance billing questions - Ensure accuracy and verify completed medical records for clinical documentation - Submit, manage, and follow up on insurance claims using Net Health and Waystar - Investigate, appeal, and resolve denied or unpaid insurance claims - Review EOBs, ERAs, authorizations, referrals, medical records, and remittance advice to ensure accurate reimbursement - Monitor aging reports and perform timely follow-up to maximize collections - Document all claim activity accurately within the billing system - Research and correct registration, demographic, and insurance issues for clean claim submission - Communicate with insurance companies, providers, and internal teams to resolve billing issues - Collaborate with Coding, Appeals & Denials, Credentialing, Cash Posting, and Patient Accounts teams - Assist patients with billing questions and payment resolution as needed - Ensure compliance with HIPAA, CMS, OIG, payer guidelines, and professional coding standards - Analyze denial trends and report findings to leadership to improve reimbursement - Maintain productivity while managing multiple priorities in a fast-paced environment Qualifications - 2+ years of medical billing, accounts receivable, or revenue cycle experience preferred - Experience with ProFee insurance claims, denials, appeals, and collections - Proficiency with Net Health, Waystar, or similar billing/EMR systems - Knowledge of EOBs, ERAs, authorizations, referrals, medical records, and payer guidelines - Understanding of Medicare, Medicaid, commercial insurance, and the revenue cycle - Familiarity with medical terminology, CPT, ICD-10, and HCPCS - Strong analytical, organizational, and problem-solving skills with attention to detail - Excellent communication skills and ability to collaborate across teams - Ability to manage a high-volume workload and meet deadlines - Knowledge of HIPAA, CMS, and healthcare compliance - Proficiency in Microsoft Excel and other business software Benefits - Home office equipment provided - Comprehensive Benefit Package - 401k - PRO & Sick Leave - STD/LTD - Compensation Range for this position: $21-25/hour based on YOE
Medical Billing Specialist – Women's Health
Inception FertilityInception is a family of fertility brands committed to helping patients build their own families.
• The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. • The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. • Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers. • Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. • Documents authorization reference numbers in EMR and/or other systems. • Updates and maintains EMR and/or other systems based on documentation provided by physician/clinic for creation of medical claim and/or posting of self-pay charges to patient accounts. • Prepares electronic claim files for submission. • Monitors accepted/denied claims and updates claims as required for resubmission. • Compares transaction reports with daily schedules to ensure timely billing of all services provided each month. • Resolves and prepares paperwork for any credit balances and prepares statements for collection of outstanding patient balances. • Performs daily charge capture functions as outlined by each Clinic in a timely and appropriate manner. This includes but not limited to the actual data entry of charges per patient into the EMR platform, eIVF. • Ensures charge reconciliation to the schedule for all patients seen daily. • Ensures appropriateness of charges based upon services rendered and works in conjunction with Clinic leadership, RCM Leadership, and Coding Team to ensure such accuracy.
• Review and accurately code profee Transplant Surgery cases to maximize reimbursement in a timely manner. • Review and accurately code E/M visits, office procedures, and surgeries. • Able to work independently and research coding scenarios. • Coder is responsible for meeting our daily production goal and our quality goal of consistently averaging a 95% accuracy rate. • Attend conference calls as necessary to provide information and feedback. • Communicate with leadership on coding or documentation issues/trends. • Stay current on all coding guidelines (including specialty - specific guidelines) and maintain credentials as necessary. • Participate in coding department and education meetings. • Flexible to expand coding skill set into other Plastic Surgery subspecialties, or other specialties altogether. • Maintain confidentiality and protect sensitive information. • Other duties as assigned by leadership.

