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