What are the responsibilities and job description for the Contracts Administrator/Billing Liaison position at HR HealthCare?
Position Summary
The Contract Administrator is responsible for the interpretation, implementation, and ongoing management of payer contracts to ensure accurate billing and reimbursement. This role serves as the operational bridge between Contracting, Billing, and IT systems, translating complex payer agreements into actionable system logic within platforms such as Brightree.
The Contract Administrator functions as the architect of reimbursement configuration, ensuring that contractual terms, fee schedules, and billing requirements are accurately reflected in internal systems and workflows to optimize revenue integrity and minimize denials.
Key Responsibilities
Education:
This position handles sensitive payer, financial, and patient-related information and must adhere to all HIPAA and company confidentiality standards.
The Contract Administrator is responsible for the interpretation, implementation, and ongoing management of payer contracts to ensure accurate billing and reimbursement. This role serves as the operational bridge between Contracting, Billing, and IT systems, translating complex payer agreements into actionable system logic within platforms such as Brightree.
The Contract Administrator functions as the architect of reimbursement configuration, ensuring that contractual terms, fee schedules, and billing requirements are accurately reflected in internal systems and workflows to optimize revenue integrity and minimize denials.
Key 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.
Education:
- Associate’s degree required; Bachelor’s degree preferred (Healthcare Administration, Business, or related field)
- 3 years of experience in healthcare billing, contracting, or revenue cycle operations
- Experience working with payer contracts and reimbursement methodologies preferred
- Proficiency in Brightree or similar billing platforms
- Strong Excel and data analysis skills
- 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
- Contract interpretation and analytical thinking
- Revenue cycle and reimbursement expertise
- Attention to detail and accuracy
- Strong communication and documentation skills
- Ability to work independently and cross-functionally
- Organizational and problem-solving skills
- Reduction in claim denials related to configuration errors
- Accuracy and timeliness of contract implementation
- Audit compliance for portal access and system configurations
- Efficiency in translating contract updates into system changes
This position handles sensitive payer, financial, and patient-related information and must adhere to all HIPAA and company confidentiality standards.