Payer Contract Specialist

ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.

This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.

CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.

Work Shift:

Day Shift

Time Type:

Full time

Department:

CC503000 CIN Administration

Summary:

Monday- Friday, 8:00 a.m.- 5:00 p.m.- Hybrid

The Payer Contract Specialist is responsible for managing payer contracts to ensure alignment with the organization's strategic financial and operational goals. This role is focused on the analysis, implementation and maintenance of fee schedules, monitoring and adherence to payer policies, and resolution of reimbursement issues to optimize revenue and contract performance. The Payer Contract Specialist collaborates closely with and supports Revenue Cycle, Physicians, Compliance, Coding, and Finance departments to identify and address payer related challenges. The specialist supports contract negotiations and serves as a liaison between internal stakeholders and payers to operationalize contract terms and maintain effective payer relationships.

Additional Information:

Monday- Friday, 8:00 a.m.- 5:00 p.m.- Hybrid

The ideal candidate will have three (3) years of the following experience:

Payer Contract Experience

• Familiarity with insurance contracts, reimbursement terms, and managed care agreements.

Data & Financial Analysis

• Comfort reviewing rates, trends, and financial reports to support decision-making.

Attention to Detail

• Ability to manage contract terms, deadlines, and compliance accurately.

Communication & Relationship-Building

• Strong skills working with payers and internal teams to resolve issues.

Regulatory Awareness

• Basic knowledge of healthcare billing, coding, and payer policies.

#AC2025

Required Education:

High school diploma or GED or equivalent

Recommended Education:

Bachelor's degree in a related field of study.

Required Work Experience:

Related Field- 3 years managed care, payer relations, payer contract, or physician or hospital billing

Recommended Work Experience:

Required Certifications:

Recommended Certifications:

Description

1. Financial and Performance Oversight:

Analyze and monitor existing and proposed payer reimbursement schedules to support contracting strategies. Manage and maintain professional reimbursement schedules and ensure timely communication of updates to stakeholders. Provide analytical support, including data collection, trend analysis, and preparation of financial reports to inform decision making

2. Contract Management:

Maintain the accuracy and integrity of the contract management system, ensuring timely and complete contract data entry. Oversee contract notices, renewals, amendments, and change management processes. Assist in the development and maintenance of reports to track and monitor contract compliance and performance metrics. Stay informed on political, legal, and regulatory trends/developments impacting managed care and payer contracting.

3. Relationship Management

Track and communicate payer policy updates and changes impacting billing, coding, reimbursement, and administrative functions. Build and maintain strong working relationships with payers and internal stakeholders. Serve as a liaison to facilitate the resolution of payer related operational issues. Act as a subject matter expert to internal stakeholders regarding contract language and professional reimbursement methodologies

4. Other Duties as assigned.