Payor Relations Specialist

Ernest Health•Plano, TX

11d

About The Position

North Texas Rehabilitation Institute is seeking a full-time Payor Relations Specialist to join its team of patient caregivers. The specialist obtains and maintains service authorizations from third-party payors to help ensure reimbursement for services provided before, throughout, and after a patient stay. The role works directly with insurers, managed care organizations, and clinical staff to help ensure patients’ treatment needs are met and to maximize their outcomes and quality of life. The institute is a participating hospital of Ernest Health. It offers recognition, wellness, and retention programs, as well as opportunities for employees to provide feedback about their work experience. Comprehensive benefits are designed to support employees’ health and financial well-being.

Requirements

A current state RN license is preferred.
Two years of recent Utilization Review experience is preferred, or an equivalent combination of education and experience.
Knowledge of clinical operations and procedures.
Knowledge of compliance and regulatory standards governing health plans and patient care.
Understanding of treatment costs and financial support as they relate to quality and efficiency.
General computer skills, including data entry, word processing, email, and record management.
Effective organizational and time management skills.
Effective written and verbal communication skills.
Ability to maintain proper levels of confidentiality.
Ability to work closely and professionally with others.
Ability to maintain quality, safety, and/or infection control standards.

Nice To Haves

Current state RN license.
Two years of recent Utilization Review experience.

Responsibilities

Obtain and maintain service authorizations from third-party payors before, throughout, and after a patient stay to ensure reimbursement for services provided.
Work directly with insurers, managed care organizations, and clinical staff to ensure patients’ treatment needs are met.
Help maximize patients’ outcomes and quality of life.

Benefits

PPO and High Deductible Medical Plan options
Flexible Spending and Health Savings Account options
Dental and Vision coverage
401K with employer matching
Life insurance
Short- and long-term disability
Employee Assistance Program
Wellness Program with quarterly wellness challenges and participation incentives
Earned Time Off, accruing from the start date
Continuing education opportunities and reimbursement
Recognition, wellness, and retention programs