Payer Contracting Specialist

Medical Consulting Group (MCG) is a leading ophthalmology consulting firm headquartered in Springfield, Missouri. We partner with physician practices, ambulatory surgery centers, and healthcare industry partners across the country to optimize revenue cycle performance, streamline payer relationships, and drive sustainable growth. Our team of experienced consultants brings deep expertise in payer contracting, ambulatory surgery center and practice management — helping clients navigate an ever-evolving healthcare landscape with confidence.

Ideal Candidate

We are seeking a skilled and motivated Payer Contracting Specialist to join our growing team in Springfield, MO. In this full-time, on-site role, you will serve as a key resource for MCG clients — negotiating favorable payer contracts and building strong relationships with both commercial and government payers on behalf of the practices and ambulatory surgery centers we serve.

The ideal candidate brings 1-3 years of hands-on experience in payer contracting from either the payer or provider prospective, a solid understanding of reimbursement methodologies, and a track record of achieving optimal contract terms for healthcare providers. If you thrive in a client-facing, detail-oriented environment, we want to hear from you.

Key Responsibilities

Payer Contract Negotiation

• Negotiate, renew, and renegotiate payer contracts on behalf of physician practices and ambulatory surgery centers.
• Analyze contract language, reimbursement rates, and reimbursement schedules to identify improvement opportunities and risks.
• Develop and present contract proposals to payers; track and document negotiation outcomes and timelines.
• Stay current on industry trends, CMS updates, and payer policy changes that may impact contract terms or reimbursement.
• Coordinate with clients to align contract strategy with their financial goals and ophthalmology-specific needs.

Client & Payer Relationship Management

• Build and maintain productive, long-term relationships with payer representatives, provider relations contacts, and MCG clients.
• Serve as a trusted advisor to clients on payer-related matters, providing guidance and actionable recommendations.
• Conduct regular check-ins with clients to review contract performance, address concerns, and identify new contracting opportunities.
• Collaborate cross-functionally with billing, coding, and revenue cycle team members to support holistic client outcomes.
• Prepare and deliver reports and presentations summarizing contract performance, benchmarks, and strategic recommendations.

Qualifications

Required

• 1-3 years of experience in payer contracting or commercial payer reimbursement management.
• Experience negotiating contracts with commercial payers (e.g., BCBS, UnitedHealthcare, Aetna, Cigna).
• Solid understanding of fee schedules, reimbursement methodologies, and contract language.
• Excellent written and verbal communication skills, with the ability to present complex information clearly.
• Strong organizational skills and the ability to manage multiple clients and priorities simultaneously.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook).

Preferred

• Experience working within a consulting firm or multi-client environment.
• Knowledge of Medicare and Medicaid contracting and enrollment requirements.
• Familiarity with practice management systems and revenue cycle software.

What We Offer

• Competitive salary commensurate with experience.
• Comprehensive benefits package including health, dental, and vision insurance.
• SIMPLE IRA with company match.
• Generous paid time off and paid holidays.
• A collaborative, mission-driven team environment in a growing consulting practice.
• Opportunity to make a meaningful impact on the healthcare providers and communities MCG serves.

Benefits:

• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Application Question(s):

• Tell us about your hands-on payer contracting experience negotiating reimbursement rates or contract terms with commercial payers (e.g., BCBS, UHC, Aetna, Cigna).
• Tell us about your experience directly leading payer contract negotiations (not just supporting), and can you briefly describe a successful outcome you achieved (e.g., rate increase, improved terms).
• Which reimbursement methodologies are you experienced working with? (Select all that apply: Medicare fee schedule, ASC rates, % of charges, case rates, bundled payments, other).

Ability to Commute:

• Springfield, MO 65804 (Required)

Work Location: In person