Payer Contracting Specialist
Job Title:
Payer Contracting Specialist
Location:
Loop Chicago, IL
Job Type:
Full-time | Direct Hire
About Neolytix
Neolytix is a healthcare management services organization (MSO) that helps healthcare providers optimize operations, increase revenue, and improve patient care. We support practices nationwide through technology-enabled services including credentialing, revenue cycle management, analytics, and digital enablement.
Position Overview
We are seeking a Payer Contracting Specialist to join our team in Chicago. This role is critical in supporting our offshore credentialing teams while taking the lead in negotiating payer contracts for mid-sized physician practices and group practices across the U.S.
You will combine hands-on execution with data-driven strategy to help our clients secure better reimbursement rates and reduce credentialing turnaround times.
Key Responsibilities
🔹 Credentialing Operations Support
Act as the U.S. liaison for offshore credentialing teams handling provider enrollments, revalidations, and payer portal submissions.
Resolve escalated credentialing issues with U.S. payers and health plans (commercial, Medicare, Medicaid).
Ensure adherence to timelines, payer guidelines, and compliance protocols.
Provide oversight on key accounts and provider credentialing KPI’s
🔹 Payer Contracting & Negotiation
Lead contract discussions with payers for mid-market practices.
Build persuasive business cases for higher reimbursement rates based on:
Practice specializations, access metrics, outcomes data
Regional need and CMS benchmarking
Patient volume, payer mix, and quality scores
Track, document, and manage contract lifecycle including renewals and renegotiations.
🔹 Analytics & Benchmarking
Leverage CMS and payer data to compare reimbursement benchmarks by region and specialty.
Support financial modeling for contract proposals and renewals.
Collaborate with internal teams to visualize trends and payer performance.
🔹 Client Engagement
Partner with client physicians, administrators, and billing managers to understand business goals.
Prepare and present strategic recommendations during client-facing meetings.
Deliver monthly reports on contract status, credentialing progress, and impact on revenue cycle.
Qualifications
✅ Required
Bachelor’s degree in healthcare administration, business, or related field.
2–3 years of experience in U.S. payer credentialing and/or payer contracting.
Understanding of commercial and government payer processes.
Experience supporting or managing offshore credentialing operations.
Strong analytical and presentation skills with working knowledge of CMS reimbursement data.
Excellent verbal and written communication skills.
✅ Preferred
Experience working with multi-specialty group practices or MSOs.
Knowledge of CAQH, PECOS, NPPES, and payer portals.
Familiarity with EMR/EHR systems and billing platforms (e.g., Kareo, Athena, eClinicalWorks).
CPCS or NAMSS certification a plus.
Compensation & Benefits
Salary Range: $65,000 – $80,000 Including a 20%performance bonus
Medical, Dental & Vision Insurance
401(k) with Company Match
Professional Development & Certification Reimbursement
Opportunity for growth into a Contracting Manager role