[Remote] Contracts Administrator/Billing Liaison
Note: The job is a remote job and is open to candidates in USA. HR HealthCare is seeking a Contracts Administrator who will be responsible for the interpretation, implementation, and ongoing management of payer contracts to ensure accurate billing and reimbursement. The role serves as a crucial link between Contracting, Billing, and IT systems, translating complex payer agreements into actionable system logic.
Responsibilities
- Contract Interpretation & System Implementation
- Analyze payer contracts, provider manuals, fee schedules, and policy bulletins to interpret reimbursement methodologies
- Translate complex insurance contract language into system-ready billing logic and internal workflows
- Implement and maintain price tables and reimbursement structures within Brightree and related systems
- Ensure allowable amounts, HCPCS codes, modifiers, and billing rules align with current payer requirements to reduce denials and write-offs
- Collaborate with Contracting to process updates and ensure timely system configuration changes
- Revenue Integrity & Compliance
- Monitor payer updates, provider bulletins, and regulatory changes impacting reimbursement
- Maintain accuracy of billing configurations to support clean claim submission and proper payment
- Partner with Billing and Medical Records teams to clarify requirements and improve documentation and billing practices
- Support audits and compliance initiatives related to payer contracts and reimbursement processes
- Portal & Access Administration
- Serve as Insurance Portal Administrator, managing access, permissions, and security in compliance with HIPAA standards
- Grant, revoke, and audit user access across multiple payer portals
- Maintain a centralized database of payer portals, credentials, and user permissions
- Act as an escalation point for portal access issues and user support
- Ensure timely deactivation of terminated employee access and perform periodic access audits
- Cross-Functional Collaboration
- Work closely with Contracting, Billing, IT, and Revenue Cycle teams to ensure accurate execution of payer agreements
- Develop and communicate clear work instructions derived from payer manuals and contract terms
- Support onboarding and training of staff on payer-specific billing requirements and system processes
Skills
- Associate's degree required
- 3+ years of experience in healthcare billing, contracting, or revenue cycle operations
- Proficiency in Brightree or similar billing platforms
- Strong Excel and data analysis skills
- Attention to detail and accuracy
- Strong communication and documentation skills
- Ability to work independently and cross-functionally
- Organizational and problem-solving skills
- Bachelor's degree preferred (Healthcare Administration, Business, or related field)
- Experience working with payer contracts and reimbursement methodologies preferred
- Experience with payer portals and systems (e.g., Inovalon)
- Understanding of HCPCS codes, modifiers, and DME billing requirements
- Experience translating provider manuals into operational workflows
- Familiarity with reimbursement modeling and price table configuration
Company Overview