Fractional Payer Relations Advisor

neobill is a new medical billing and revenue optimization firm focused on independent practices, and I'm looking for a seasoned payer relations professional to serve as a fractional advisor to our clients and help us build the payer relations function from the ground up.

This is a low-utilization, on-call engagement, well suited for someone currently consulting, semi-retired from a system executive role, or wanting a steady side engagement alongside existing work. We're a brand-new firm, so usage will start light (roughly 5 to 10 hours per month) and grow as our client base grows. As one of our first team members, you'll help shape how this function actually runs. You'll be defining our Payer Contract Audit methodology with me, not inheriting it.

You'd be called in for two types of work

1. Payer Contract Audit (primary deliverable). For prospect and client practices, you'd produce:

• Fee schedule benchmarking: contracted rates vs. Medicare and market comps across the practice's top CPTs
• Underpayment and payment integrity analysis: EOB data matched against contract fee schedules to find payer underpayments
• Payer mix and profitability analysis: which payers are worth keeping, renegotiating, or dropping
• Contract language review: flagging one-sided termination rights, silent PPO clauses, timely filing traps, unilateral fee schedule amendment rights, appeal windows, carve-outs

2. Systemic denial escalation. When a client is getting hit repeatedly by the same payer for the same reason and claim-level appeals aren't solving it, you triage the pattern (is this coding, enrollment, contract interpretation, or a payer policy issue?) and escalate through your provider relations contacts or state regulatory channels when warranted.

Across both, you own the written client deliverables. Every Payer Contract Audit, underpayment memo, and escalation writeup is yours: you define what the report looks like, build the template so it's repeatable, and hold the professional quality bar. These documents are often the first thing a practice owner forwards to their partners or their attorney, so the bar is high.

Explicitly not a legal advisor and not a claim-level appeals biller. Those responsibilities live elsewhere on the team. This is the “above the claim” role.

What I'm looking for

• 7+ years in payer contracting, network management, or provider relations
• Experience inside a large enterprise health system (Northwestern, Rush, UChicago Medicine, Advocate, Endeavor, or similar) or a national commercial payer
• Direct experience negotiating commercial contracts with BCBS, UnitedHealthcare, Aetna, Cigna, and Humana
• Illinois payer fluency strongly preferred: BCBS IL, Illinois Medicaid, and the major local MCOs
• Working relationships with provider relations contacts at major payers is a strong plus
• Experience with behavioral health carve-outs (UBH/Optum, Magellan, Beacon) is a plus given our specialty focus
• Discretion and a relationship-first posture. You know this world runs on trust.
• Strong professional writing. You produce clean, client-ready reports and memos without heavy editing, because these documents go directly to practice owners and their advisors.
• Comfort with startup ambiguity. Willing to help define the service and refine the audit methodology as we learn.

Engagement & logistics

• 1099 retainer plus hourly at senior consultant rates, with a defined response SLA
• Referral agreement for any practice you introduce that becomes a Neobill client
• Non-exclusive. Continuing your other consulting or executive work is expected and encouraged.
• HIPAA training and signed BAA required before any client work
• Direct working relationship with me (the founder)

If this is you (or someone in your network), pleas email dylan@neobill.co. Happy to have a quick intro call.

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