Payor Relations Lead - Dallas, TX

United Allergy Services-posted 9 months ago
Full-time • Mid Level
Remote
Plastics and Rubber Products Manufacturing
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As a Payor Relations Lead, you will play a crucial role on our payor relations and revenue cycle support team and in our mission to provide accessible allergy care by helping the business with payor relations strategic relationships, monitoring and responding to regulatory policies, transactional payor activities and projects and influencing payor decisions.

  • Responsible for assisting in the identification, development and coordination of strategic relationships with payors and organizations that influence payor decision-making.
  • Continuous monitoring of federal, state, and payor policies that impact reimbursement of supported services.
  • Execute ongoing and ad-hoc reporting requests and other project assignments issued by Revenue Cycle and Payor Relations.
  • Responsible for continuous system and data integrity maintenance to ensure leadership can be confident in data driven decision making.
  • Completing transactional case work on a day-to-day basis, with a focus on training and quality assurance of Tier 1 case workers, and review and delivery of guidance for Tier 2 issues.
  • Bachelor's degree in business or other commensurately equivalent program or five (5) to seven (7) years of recent and equivalent work experience in payor relations role.
  • At least three (3) years' experience in a healthcare and/or health insurance related environment is required.
  • In depth understanding of healthcare benefits (HMO, PPO, ACO, Medicare, Medicaid, etc.) is required.
  • Basic understanding and experience with Revenue Cycle Management.
  • Prior personal health claim billing and coding experience is required.
  • Comprehensive knowledge of standard medical documentation requirements, Insurance appeal process, EMR systems, and experience with Salesforce will aid with success.
  • Customer Relationship Management (CRM) system experience is preferred.
  • Experience with virtual communications tools, such as Teams, Zoom, Webex, etc. is preferred.
  • Experience in public speaking and able to present to and manage meetings and communications with large groups.
  • PTO and Company Holidays
  • Medical (PPO & HDHSA), dental, vision, and life insurance are available.
  • Company 401(k) retirement plan with match.
  • Employee Assistance Program (EAP)
  • Daytime, business week schedule.
  • Ability to work virtually first most of the time.
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