Payer Contracting Specialist

4 Hours ago • 2-3 Years • $65,000 PA - $96,000 PA

Job Summary

Job Description

The Payer Contracting Specialist role involves supporting offshore credentialing teams and leading payer contract negotiations for mid-sized physician practices across the U.S. Key responsibilities include resolving credentialing issues, negotiating contracts, analyzing reimbursement data, and preparing client-facing reports. The specialist will work with clients to understand business goals, provide strategic recommendations, and manage contract lifecycles. This role requires a blend of hands-on execution and data-driven strategy to optimize revenue and reduce credentialing turnaround times.
Must have:
  • Bachelor’s degree in healthcare or related field.
  • 2–3 years of experience in U.S. payer credentialing.
  • Understanding of commercial and government payer processes.
  • Experience supporting offshore credentialing operations.
  • Strong analytical and presentation skills.
Good to have:
  • Experience working with multi-specialty group practices.
  • Knowledge of CAQH, PECOS, NPPES, and payer portals.
  • Familiarity with EMR/EHR systems and billing platforms.
  • CPCS or NAMSS certification a plus.
Perks:
  • Medical, Dental & Vision Insurance
  • 401(k) with Company Match
  • Professional Development & Certification Reimbursement
  • Opportunity for growth into a Contracting Manager role

Job Details

Job Title: 

Payer Contracting Specialist 

Location: 

Loop Chicago, IL 

Job Type: 

Full-time | Direct Hire 

About Neolytix 

Neolytix is a healthcare management services organization (MSO) that helps healthcare providers optimize operations, increase revenue, and improve patient care. We support practices nationwide through technology-enabled services including credentialing, revenue cycle management, analytics, and digital enablement. 

Position Overview 

We are seeking a Payer Contracting Specialist to join our team in Chicago. This role is critical in supporting our offshore credentialing teams while taking the lead in negotiating payer contracts for mid-sized physician practices and group practices across the U.S. 

You will combine hands-on execution with data-driven strategy to help our clients secure better reimbursement rates and reduce credentialing turnaround times. 

Key Responsibilities 

🔹 Credentialing Operations Support 

  • Act as the U.S. liaison for offshore credentialing teams handling provider enrollments, revalidations, and payer portal submissions. 

  • Resolve escalated credentialing issues with U.S. payers and health plans (commercial, Medicare, Medicaid). 

  • Ensure adherence to timelines, payer guidelines, and compliance protocols. 

  • Provide oversight on key accounts and provider credentialing KPI’s 

🔹 Payer Contracting & Negotiation 

  • Lead contract discussions with payers for mid-market practices. 

  • Build persuasive business cases for higher reimbursement rates based on: 

  • Practice specializations, access metrics, outcomes data 

  • Regional need and CMS benchmarking 

  • Patient volume, payer mix, and quality scores 

  • Track, document, and manage contract lifecycle including renewals and renegotiations. 

🔹 Analytics & Benchmarking 

  • Leverage CMS and payer data to compare reimbursement benchmarks by region and specialty. 

  • Support financial modeling for contract proposals and renewals. 

  • Collaborate with internal teams to visualize trends and payer performance. 

🔹 Client Engagement 

  • Partner with client physicians, administrators, and billing managers to understand business goals. 

  • Prepare and present strategic recommendations during client-facing meetings. 

  • Deliver monthly reports on contract status, credentialing progress, and impact on revenue cycle. 

Qualifications 

✅ Required 

  • Bachelor’s degree in healthcare administration, business, or related field. 

  • 2–3 years of experience in U.S. payer credentialing and/or payer contracting. 

  • Understanding of commercial and government payer processes. 

  • Experience supporting or managing offshore credentialing operations. 

  • Strong analytical and presentation skills with working knowledge of CMS reimbursement data. 

  • Excellent verbal and written communication skills. 

✅ Preferred 

  • Experience working with multi-specialty group practices or MSOs. 

  • Knowledge of CAQH, PECOS, NPPES, and payer portals. 

  • Familiarity with EMR/EHR systems and billing platforms (e.g., Kareo, Athena, eClinicalWorks). 

  • CPCS or NAMSS certification a plus. 

Compensation & Benefits 

  • Salary Range: $65,000 – $80,000 Including a 20%performance bonus 

  • Medical, Dental & Vision Insurance 

  • 401(k) with Company Match 

  • Professional Development & Certification Reimbursement 

  • Opportunity for growth into a Contracting Manager role 

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