Contracts and Payor Credentialing Specialist FT, 1

NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. In a variety of locations and community-based settings, we offer a range of programs, including vocational and therapy programs, day treatments, and specialized services for infants, children, adolescents, Military Service Members and Veterans.
Contracts and Payor Specialist - Remote
The Contracts and Payor Specialist is responsible for identifying and securing public and private insurance contracts; reviews and organizes existing contracts. Assists with the development of potential relationships with strategic partners and creates measurable business results for various markets. Responsible for credentialing of licensed clinicians.
Contracting and Credentialing

Works in partnership with Program Directors and Director of Contracts and Payor Engagement to ensure consistency and secure public and private insurance contracts

Analyzes and monitors financial aspects of existing contracts and maintains original documentation of all contracts

Completes contract related credentialing and enrollment application requirements

Identifies, contacts, and creates relationships with potential payors that result in new contracts and increased funding possibilities for program participants

Conducts rate and contract negotiations

Describes Client programs to potential contract sources

Communicates with state directors, and state operating/marketing staff regarding contract specifics. Ensures commitments to participants, family, referral sources and payors are met

Maintains database of licenses, accreditation forms, financial and organizational information for the purpose of efficient and timely enrollment application

Oversees Single Case Agreement process within the Admissions Teams. May take lead in difficult single case negotiation

Other Duties:

Communicates contract executions and requirements to all internal departments

Facilitates resolution of contract related issues with billing and collections team

Performs other related duties, projects, and activities as required

Qualifications:

Bachelor’s degree in Rehabilitation Administration, Business Administration or related field preferred

Three to five years’ experience with contracts, managed care, and health insurance related industry preferred

Prior credentialing experience a must

A reliable, responsible attitude and a compassionate approach

A commitment to quality in everything you do

Experience with CAQH a plus

Why Join Us?

Full time position

Full compensation/benefits package for employees working 32+ hours/week

401(k) with company match

Paid time off and holiday pay

Rewarding work, impacting the lives of those you serve, working alongside a great team of coworkers

Enjoy job security with nationwide career development and advancement opportunities

We have meaningful work for you – come join our team – Apply Today!
Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face. We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.
As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.
Originally posted on Himalayas