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Payer Negotiation Specialist

74B8425BF3D1B3ACB19CC1353DC5FA0E · Clearwater, FL 33759; 311 Park Place, Clearwater, FL, 33759, USA · Remote · Active · $26–$36 / hour · Paycom ATS

Job facts

FieldValue
Company74B8425BF3D1B3ACB19CC1353DC5FA0E
TitlePayer Negotiation Specialist
Normalized title-
Department / team-
LocationClearwater, FL, United States
Work modelRemote / Remote
Employment type-
Salary$26–$36 / hour
Statusactive
ATS providerPaycom ATS
Posted / first seen2026-04-02 / 2026-05-31
Changed / last seen2026-05-31 / 2026-06-06

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Linked records

Company74B8425BF3D1B3ACB19CC1353DC5FA0E
Source8e95c952-4385-40c5-8a8a-e5b3b79cbae9
ATS providerPaycom ATS

Description

Description Position Summary The Single Case Agreement (SCA) Specialist is responsible for securing reimbursement and coverage for services, therapies, or medical technologies on a patient-by-patient basis through negotiation with health plans. This role serves as a key liaison between providers, payers, patients, and internal teams to ensure timely access to care when standard coverage pathways are not available. About RomTech ROMTech® is a groundbreaking telemedicine technology with remote clinical oversight and fully customizable therapy protocols. The PortableConnect® (the device) enables gentle, therapeutic movement within a comfortable range of motion. Light, easy, and frequent sessions make it easier for the body to heal and recover. The result: patients recover and return to their activities of daily living more quickly, with less pain and drugs, and with better mobility. Key Responsibilities o Initiate and lead negotiations with commercial and government health plans to establish Single Case Agreements (SCAs) o Secure appropriate reimbursement rates, terms, and coverage conditions for out-of-network or non-contracted services o Communicate clinical and economic value propositions to payer medical directors and contracting teams o Manage a pipeline of patient-specific cases from intake through agreement execution and reimbursement o Coordinate with clinical, reimbursement, and intake teams to gather necessary documentation (e.g., medical necessity, prior authorizations) o Track case progress, timelines, and outcomes to ensure timely patient access · Documentation & Compliance o Draft, review, and finalize SCA contracts in collaboration with legal and compliance teams o Ensure all agreements adhere to payer requirements, regulatory standards, and internal policies o Maintain accurate records of negotiations, approvals, and contract terms · Cross-Functional Collaboration o Partner with providers, revenue cycle teams, and patient access teams to align strategy and communication o Educate internal stakeholders on payer requirements, negotiation strategies, and SCA processes o Serve as a subject matter expert on reimbursement pathways for non-covered or out-of-network services Qualifications Qualifications · 3–7+ years of experience in healthcare reimbursement, payer relations, managed care contracting, or revenue cycle · Proven experience negotiating with health plans (SCAs, LOAs, or out-of-network agreements preferred) · Strong understanding of prior authorization, medical necessity, and appeals processes · Knowledge of commercial insurance, Medicare, and Medicaid structures Key Skills · Strong negotiation and influencing skills · Ability to communicate clinical and financial value effectively · Detail-oriented with strong organizational and case management abilities · Comfortable working in fast-paced, high-stakes patient access environments · Excellent written and verbal communication skills Preferred Experience · Experience working with specialty therapies, medical devices, or high-cost procedures · Familiarity with CPT/HCPCS coding and reimbursement methodologies · Prior interaction with payer medical directors or utilization management team Physical Demands and Working Conditions The following describes the physical demands and work environment characteristics required to perform the essential functions of this position. These requirements are representative of those an employee may encounter while performing the job and are not intended to be an exhaustive list. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role. Ability to sit at a computer terminal for an extended period. Moderate noise (i.e., phone calls, online meetings, computer audio) While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard. Specific vision abilities required by this job include close vision requirements due to computer work. Regular, predictable attendance is required. Must be able to communicate clearly and professionally in both verbal and written formats. Must be able to engage in active listening and express ideas effectively in person, by phone, and via virtual meetings. 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 accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing [email protected] .

Full job record

Job IDbd3e4c2864a82a72572157a8885b61148cb3d70a
Org ID18d8383b-347f-4934-9fe7-c22882d761e9
Source ID8e95c952-4385-40c5-8a8a-e5b3b79cbae9
Board ID8e95c952-4385-40c5-8a8a-e5b3b79cbae9
Providerpaycom
Provider Job Key20250
TitlePayer Negotiation Specialist
Normalized Title
Statusactive
Activeyes
Location TextClearwater, FL 33759; 311 Park Place, Clearwater, FL, 33759, USA
Department
Team
Employment Type
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionFL
CityClearwater
Salary Raw$26.00 - $36.00 Hourly
Salary Min26
Salary Max36
Salary CurrencyUSD
Salary Periodhour
Source URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=20250&clientkey=74B8425BF3D1B3ACB19CC1353DC5FA0E
Apply URLhttps://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=20250&clientkey=74B8425BF3D1B3ACB19CC1353DC5FA0E
First Seen At2026-05-31 19:06:09Z
Last Seen At2026-06-06 09:51:44Z
Last Checked At2026-06-06 09:51:44Z
Last Changed At2026-05-31 19:06:09Z
Inactive At
Source Posted At2026-04-02 00:00:00Z
Source Updated At
Raw Payload Uris3://job-postings-prod-raw-590183727216/raw/provider=paycom/board=74B8425BF3D1B3ACB19CC1353DC5FA0E/date=2026-06-06/2026-06-06T09-51-42-918Z-54a84af728fdc2e339030ee81e2c656a3b29c5512d1a1624c71c79955a3d1784.json
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    "qualifications": "<p>Qualifications</p>\n\n<p>&nbsp;</p>\n\n<p>&middot; 3&ndash;7+ years of experience in healthcare reimbursement, payer relations, managed care contracting, or revenue cycle</p>\n\n<p>&middot; Proven experience negotiating with health plans (SCAs, LOAs, or out-of-network agreements preferred)</p>\n\n<p>&middot; Strong understanding of prior authorization, medical necessity, and appeals processes</p>\n\n<p>&middot; Knowledge of commercial insurance, Medicare, and Medicaid structures</p>\n\n<p>&nbsp;</p>\n\n<p>Key Skills</p>\n\n<p>&nbsp;</p>\n\n<p>&middot; Strong negotiation and influencing skills</p>\n\n<p>&middot; Ability to communicate clinical and financial value effectively</p>\n\n<p>&middot; Detail-oriented with strong organizational and case management abilities</p>\n\n<p>&middot; Comfortable working in fast-paced, high-stakes patient access environments</p>\n\n<p>&middot; Excellent written and verbal communication skills</p>\n\n<p>Preferred Experience</p>\n\n<p>&nbsp;</p>\n\n<p>&middot; Experience working with specialty therapies, medical devices, or high-cost procedures</p>\n\n<p>&middot; Familiarity with CPT/HCPCS coding and reimbursement methodologies</p>\n\n<p>&middot; Prior interaction with payer medical directors or utilization management team</p>\n\n<p><strong>Physical Demands and Working Conditions</strong></p>\n\n<p>The following describes the physical demands and work environment characteristics required to perform the essential functions of this position. These requirements are representative of those an employee may encounter while performing the&nbsp;job&nbsp;and are not intended to be an exhaustive list. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the role.</p>\n\n<ul>\n\t<li>\n\t<p>Ability to sit at a computer terminal for an extended period.&nbsp;</p>\n\t</li>\n\t<li>\n\t<p>Moderate noise (i.e., phone calls, online meetings, computer audio)&nbsp;</p>\n\t</li>\n\t<li>\n\t<p>While performing the duties of this&nbsp;job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.&nbsp;</p>\n\t</li>\n\t<li>\n\t<p>Specific vision abilities required by this&nbsp;job&nbsp;include close vision requirements due to computer work.&nbsp;</p>\n\t</li>\n\t<li>\n\t<p>Regular, predictable attendance is required.&nbsp;</p>\n\t</li>\n\t<li>\n\t<p>Must be able to communicate clearly and professionally in both verbal and written formats.</p>\n\t</li>\n\t<li>\n\t<p>Must be able to engage in active listening and express ideas effectively in person, by phone, and via virtual meetings.</p>\n\t</li>\n</ul>\n\n<p>The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this&nbsp;job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Reasonable accommodation requests must be made in writing by emailing&nbsp;<a href=\"mailto:[email protected]\">[email protected]</a>.</p>\n",
    "descriptionTitle": "Description",
    "travelPercentage": "",
    "jobYoutubeVideoId": "",
    "legalRevisionDate": {
      "date": "2025-12-18T16:29:25.000Z",
      "timezone": "America/Chicago",
      "timezone_type": 3
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    "primaryPhoneCountry": "US",
    "primaryPhoneEnabled": false,
    "qualificationsTitle": "Qualifications",
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  },
  "preview": {
    "jobId": 20250,
    "isHotJob": false,
    "jobTitle": "Payer Negotiation Specialist",
    "postedOn": "",
    "locations": "Clearwater, FL 33759",
    "remoteType": "",
    "description": "Position Summary\n\nThe Single Case Agreement (SCA) Specialist is responsible for securing reimbursement and coverage for services, therapies, or medica...",
    "positionType": ""
  },
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