[Remote] Health Care Payer Network & Credentialing Consultant and Healthcare Claims Auditor & Payer Negotiations Specialist

Note: The job is a remote job and is open to candidates in USA. Healthcare Building Solutions is seeking an Independent Consultant to help healthcare organizations expand their reach and secure the right payer contracts. The consultant will guide providers through the payer network application process and analyze service lines to recommend strategic payer networks. Responsibilities • Guiding providers through the payer network application process – commercial, Medicare, Medicaid, commercial managed care, Medicare/Medicaid managed care, other • Navigating and meeting credentialing requirements • Analyzing service lines and market data to recommend the most strategic payer networks for specific healthcare services and regions Skills • Proven experience in healthcare payer enrollment & credentialing • Strong knowledge of payer requirements and state/regional variations • Analytical skills to assess market opportunities • Excellent communication and client relationship skills • RN or Advanced Practiced Nurse with substantial experience in healthcare claims auditing and compliance • Expertise in payer regulations, CMS billing guidelines, and managed care contracts • Strong negotiation skills with a proven track record of successful appeals • Ability to interpret complex medical records, coding data, and payer policies Benefits • Flexible, independent contractor role • Opportunities to collaborate with a network of health care consulting professionals making a real difference in care delivery Company Overview • Healthcare Building Solutions (HBS) offers solutions for your complete project success. It was founded in 2007, and is headquartered in Langhorne, Pennsylvania, USA, with a workforce of 51-200 employees. Its website is Apply tot his job