Job Type
Full-time
Description
Contract/Credentialing Specialist
Location: Lexington, KY
Schedule: Monday-Friday 8am-5pm; optional 1 day remote.
*May be required to work in office upon hire during the introductory period.
Join BCN- recognized as a Top 10 Best Places to Work in Kentucky for 2 years in a row!
At BCN we are committed to a work setting that treats all team members with fairness, dignity, and respect. We offer our team members an opportunity to grow, to develop professionally, and to work in a team environment. You can help our team make a lasting difference for our families. Join #TeamBCN where your work matters and your time is valued.
We Offer:
- Competitive Pay
- Comprehensive benefits package
- Remote and Hybrid work opportunities (select positions)
- Autonomy in your workday
- Flexible Schedules to support work/life balance (select positions)
- Mileage Reimbursement for work-related driving
- Up to 24 days of PTO accrued within the first year of employment
- 8 Paid Holidays (including day after Thanksgiving and Christmas Eve)
- Educational Assistance up to $3,000 per year & College Tuition Discounts
- Free Continuing Education Credits
About the role:
Responsible for all aspects of contract management. Ensuring all contracts are properly drafted, negotiated, executed, and managed throughout their lifecycle.
Requirements
- Bachelor’s degree in a relevant field such as business, law, contract management, or a related discipline; 3-5 years of previous contract management experience; or equivalent combination of education and experience. An advanced degree such as a Master of Healthcare Administration (MHA) or a Master of Business Administration (MBA) with a focus on healthcare is preferred.
- A strong understanding of contract law principles, legal concepts and healthcare regulations is essential. A solid understanding of the healthcare industry, including knowledge of healthcare systems, insurance and reimbursement models, and government programs (such as Medicare and Medicaid), is essential.
- Knowledge of healthcare reimbursement methodologies, payor policies, and coding and billing guidelines.
- Knowledge with contract drafting negotiation, interpretation, and contract lifecycle management.
- Strong negotiation and communication skills to effectively interact with providers.
- Analytical skills to assess contracts, reimbursement rates, identify risks and payment discrepancies, communication skills to effectively interact with providers and propose appropriate mitigations strategies.
- Understanding of regulatory compliance requirements in the healthcare industry with specifics in PACE, Hospice, Home Health to name a few.
- Ability to build and maintain positive relationships with providers.
- Attention to detail and accuracy in reviewing contracts and reimbursement information.
- Proficiency in contract management, data analysis, and reporting tools.
- Problem-solving skills to resolve payment disputes and address provider concerns.
- Contract certification preferred.
- Employee will be expected to comply with Bluegrass Care Navigators (BCN) Employee Health, infectious disease, and vaccination policies.
- Must be a licensed driver with automobile that is insured in accordance with state and/or BCN requirements and is in good working order.
Salary Description
$58,418-$75,944 per year