Payor Relations Coordinator

FMOLHS • Baton Rouge, LA

5d

About The Position

The Payor Relations Coordinator assists with the financial analysis, development, and maintenance of managed care contracts and ensures that payors reimburse FMOLHS and affiliated entities correctly. The role serves as a liaison among the Business Office, Medical Management, Revenue Management, and other internal departments to resolve identified issues.

The position supports managed care contract analysis and strategy, contract negotiations, communication of process changes, and collaboration with internal departments, contracted payers, and affiliated entities to optimize reimbursement and resolve reimbursement, operational, and clinical issues.

Requirements

• Three years of professional-level hospital or managed care experience.
• Bachelor's degree.

Responsibilities

• Assist in developing and maintaining financial information about volume, financial performance, and profitability for each managed care contract.
• Prepare preliminary interpretations of analyses for project teams, departments, and/or management.
• Assist in developing reimbursement strategies, policies, and procedures related to contract negotiations.
• Maintain current knowledge of the managed care environment, including local, state, and national developments, and develop and maintain relationships with appropriate agencies.
• Assist in contract negotiations.
• Communicate changes in managed care processes to FMOLHS and affiliated entity employees and help ensure those changes are followed in a way that supports high-quality patient care.
• Stay current with trends in the field through participation in job-relevant seminars and workshops.
• Collaborate with internal departments, including Financial Operations, Revenue Management, and the Business Office, to optimize reimbursement and resolve identified issues.
• Assist with resolution of operational issues involving contracted payers, including reimbursement, operational, and clinical issues.
• Work with affiliated entities to develop and maintain managed care contracts and strategies.

What This Job Offers

• Job Type: Full-time