Payor Credentialing and Pricing Specialist Job at Confidential, Research Triangle Park, NC

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  • Confidential
  • Research Triangle Park, NC

Job Description

job summary:
Looking to elevate your healthcare career with an industry giant? A Top-Tier Global Pharma Leader is seeking a driven Payor Credentialing and Pricing Specialist for a 6-month hybrid contract (2 days/week on-site) in Research Triangle Park (RTP), Durham, NC. In this critical role, you will act as the operational bridge between legal contracts and revenue realization, ensuring complex commercial accounts are accurately established and maintained.

location: Durham, North Carolina
job type: Contract
salary: $23 - 24 per hour
work hours: 9 to 5
education: Bachelors

responsibilities:

  • Review executed commercial client contracts to identify billing-related changes and execute accurate pricing setups.
  • Update and maintain payor accounts, billing system configurations, and hierarchies within Salesforce and Xifin.
  • Prepare, submit, and rigorously track provider and laboratory credentialing and enrollment forms.
  • Drive persistent, professional follow-up with commercial payors via phone and email to expedite applications.
  • Proactively troubleshoot billing workflows independently while collaborating across Market Access, Revenue Cycle, and Finance teams.
  • Ensure strict data integrity and adherence to CLIA, CAP, and HIPAA regulatory guidelines.
 
qualifications:
Required:

  • Direct experience in healthcare billing, specifically working with private/commercial insurance payors (e.g., BCBS, Cigna) rather than government-run programs.
  • Proven experience with contract review, pricing implementation, and system account setups.
  • Strong written and verbal communication skills with a highly persistent, professional follow-up style.
  • A self-starting mindset with the ability to troubleshoot problems independently without explicit direction.
Preferred:

  • Prior hands-on experience utilizing Salesforce and Xifin billing systems.
  • Bachelor's degree in Healthcare Administration, Finance, Business, or a related field.
 
skills: HIPAA Compliance, Customer Relationship Management (CRM) software


Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.


Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).


This posting is open for thirty (30) days.

Job Tags

Hourly pay, Contract work, Temporary work, Work experience placement, 2 days per week

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