Associate Payor Operations Specialist
About The Position
The Associate Payor Operations Specialist is an entry-level professional position supporting the day-to-day operations of the BILHPN Payor Operations department under the direction of the Director, Payor Operations. The role supports coordination and tracking of payor requirements, deliverables, communications, alerts, meetings, and follow-up activities, and assists with value-based care agreements. It works collaboratively with internal BILHPN teams and external payor partners while providing operational support to practices, provider groups, Revenue Cycle teams, and other stakeholders. The position is designed to build foundational knowledge of payor operations, value-based care, healthcare operations, provider practice workflows, revenue cycle processes, stakeholder engagement, and issue resolution, while progressively developing skills for greater responsibility. The position requires maintaining effective working relationships, adhering to BILH and BILHPN policies, and providing courteous, service-oriented support. The employee also participates in quality improvement activities, completes mandatory education, and performs other duties as needed or directed. The role requires a high degree of mental and visual concentration, lifting or moving light weights up to 20 pounds, average manual coordination and range of motion, constant repetitive motion, and minimal exposure to environmental elements. The duties generally do not involve hazardous materials. The position has no patient care or contact and does not facilitate the patient care process or directly impact health outcomes. The listed annual base salary range is $25.00–$38.00 USD. Actual compensation may depend on factors including seniority, education, training, relevant experience, certifications, work location, and job responsibilities. Staff are required to be vaccinated against influenza as a condition of employment.
Requirements
- Bachelor's degree in healthcare management, administration, public health, business administration, health services, communications, or a related field preferred; equivalent relevant education and/or experience may be considered.
- 0–2 years of experience in healthcare operations, payor operations, provider relations, practice operations, revenue cycle, customer service, business administration, or a related field preferred.
- Strong organizational skills and attention to detail.
- Excellent written and verbal communication skills.
- Professional interpersonal skills and a demonstrated service orientation.
- Ability to establish positive working relationships with payor representatives, practices, provider groups, Revenue Cycle teams, internal departments, and other stakeholders.
- Ability to manage multiple tasks, track follow-up, meet deadlines, and seek guidance when priorities conflict.
- Ability to learn and apply healthcare operations, value-based care, payor requirements, and organizational workflows.
- Strong documentation, meeting coordination, follow-through, and customer service skills.
- Proficiency with Microsoft Word, Excel, PowerPoint, Outlook, Teams, and related business applications.
- Demonstrated willingness to learn, receive coaching, and progressively assume greater responsibility.
- Strong analytical skills and proficiency in data analysis tools and software.
- Collaborative and team-oriented.
- Must meet the employer's influenza vaccination condition of employment.
- No licensure, certification, or registration is required.
Nice To Haves
- Healthcare or provider-facing experience.
- Familiarity with Smartsheet or similar tracking/workflow tools.
Responsibilities
- Track payor deliverables, requirements, deadlines, alerts, notifications, and other payor-related action items.
- Maintain accurate and organized inventories and tracking tools for payor deliverables, requests, communications, issues, and resolutions.
- Coordinate with payor representatives and internal stakeholders to obtain information, confirm requirements, and support timely follow-up.
- Support payor-specific meetings by coordinating schedules, preparing materials, documenting notes and action items, and completing follow-up.
- Assist with intake, documentation, and routing of payor communications, requests, and operational issues to the appropriate BILHPN team or stakeholder.
- Compile payor requirements, contract-related information, reports, reference materials, and other documentation for internal stakeholders.
- Support dissemination of payor alerts, notifications, program updates, training information, and operational requirements under Payor Operations leadership.
- Work with practices and provider groups on questions, requests, payor-related operational needs, and follow-up, escalating matters requiring additional expertise or authority.
- Coordinate with Revenue Cycle teams and other operational stakeholders to research and track payor-related claims, billing, reimbursement, enrollment, or workflow issues, as applicable.
- Gather information from practices, providers, Revenue Cycle, operations, clinical teams, and other stakeholders to support resolution of payor-related issues.
- Monitor deliverable status and identify upcoming deadlines, missing information, barriers, or potential risks for escalation to Payor Operations leadership.
- Maintain and refine standard workflows, reference materials, spreadsheets, Smartsheet trackers, and other payor operations tools.
- Prepare routine reports, spreadsheets, presentations, correspondence, meeting summaries, and status updates under Payor Operations leadership.
- Develop and maintain effective working relationships with payor representatives, practices, provider groups, Revenue Cycle teams, BILHPN operational teams, and other stakeholders.
- Participate in training, mentoring, and professional development activities to build proficiency and progressively assume greater responsibility.
- Adhere to BILH and BILHPN policies and maintain courteous, effective interactions with colleagues, providers, and stakeholders.
- Participate in departmental or interdepartmental quality improvement activities and complete mandatory education.
- Perform other duties as needed or directed to meet departmental needs.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
