BioMatrix Specialty Pharm

Compensation

Full Description

Company Overview: BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.   The Contract Administrator and Credentialing Specialist Infusion is a dual-role position ensures that all pharmacy and provider contracts, payor agreements, and credentialing files are accurate, up to date, and in compliance with regulatory and organizational standards. The ideal candidate will have a strong background in healthcare administration, credentialing, and contract management, with the ability to work independently and collaboratively across departments.    QUALIFICATION REQUIREMENTS * Associate’s degree required; Bachelor’s degree in Healthcare Administration, Business Administration, or related field strongly preferred. * Minimum of 2–3 years of experience in credentialing and/or payor contracting within a healthcare setting. * Strong knowledge of provider enrollment, credentialing standards, and healthcare regulations. * Proficiency with CAQH, PECOS, NPPES, and payor portals. * Demonstrated organizational skills with the ability to manage multiple priorities and meet deadlines. * Excellent verbal and written communication skills with strong attention to detail.   QUALIFICATIONS PREFERRED * Experience in home infusion, specialty pharmacy, or physician group practice credentialing/contracting. * Familiarity with managed care payor agreements, contract language review, and negotiation support. * Experience with database management systems or credentialing software solutions. * Knowledge of billing, reimbursement models, and payer/provider network management.   ESSENTIAL FUNCTIONS AND RESPONSIBILITIES * Manage end-to-end credentialing and recredentialing processes for pharmacy operations and clinical providers (MDs, NPs, etc.). * Prepare, complete, and submit applications to health plan payors, PBMs, and credentialing bodies, ensuring accuracy and timeliness. * Maintain and update payor files, including credentialing documentation, contracts, and correspondence. * Ensure all licenses, certifications, and supporting documentation are accurately maintained and kept up to date for credentialing and contracting processes. * Track and monitor contract renewals, expirations, amendments, and termination dates. * Collaborate with cross-functional teams (clinical, compliance, finance, legal, and operations) to ensure seamless credentialing and contract workflows. * Ensure compliance with federal, state, and accreditation standards related to credentialing and provider contracts. * Respond to payor and provider inquiries regarding credentialing, contract status, and compliance.   NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES * Assist with special projects and audits as assigned. * Support process improvement initiatives related to credentialing and contract management. * Provide backup support to other team members during high-volume periods or absences. * Participate in staff meetings, training, and professional development activities.   KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS * Analytical Skills: Ability to review, interpret, and verify detailed documents, contracts, and compliance requirements. * Communication: Strong written and verbal skills with the ability to interact professionally across internal teams and external stakeholders. * Attention to Detail: Highly organized and meticulous in maintaining accurate records and compliance standards. * Problem-Solving: Ability to troubleshoot credentialing or contract-related issues and propose solutions. * Technical Proficiency: Comfortable working with MS Office Suite, credentialing software, and payor portals. * Adaptability: Capable of working in a fast-paced, evolving healthcare environment. * Team Collaboration: Willingness to work cross-functionally to support organizational goals. PHYSICAL DEMANDS AND WORK ENVIRONMENT * This position requires constant sitting with occasional walking, standing, kneeling or stooping. * This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms. * This position requires constant talking and hearing. * Specific vision abilities required by this job include close vision and the ability to adjust focus. * This position must occasionally lift and/or move up to 20 pounds * Required to move/lift physical hardware.   AMERICANS WITH DISABILITY SPECIFICATIONS  PHYSICAL DEMANDS  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.  While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop; kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.    OTHER  * Will participate in legal and ethical compliance training each year. * Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures. * Will abide by the policies of BioMatrix LLC as set forth in the Compliance Manual. * Will not participate in any conduct considered to be unethical or illegal.   EXPECTATION FOR ALL EMPLOYEES  Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm.   GENERAL INFORMATION:  The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified. The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate. Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals to ensure access to the organization's services (may include visitors, patients, employees, or others).   All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.