Payor Specialist- Atrium Health CMC Remote PRN
About The Position
Communicates clinical information and negotiates with payors to obtain authorization for appropriate level of care and length of stay. Ensures payor and customer satisfaction through effective communication and positive customer service skills at all times. Provides prompt feedback regarding payor determinations to appropriate staff. Obtains preferred provider and benefit information for home care, DME and post acute services. Maintains and enters certification information in appropriate information system. Communicates any change in payor information to Outcomes Manager/Care Coordinator. Documents changes appropriately. Must be able to handle fast paced environment. Must have the ability to communicate clearly in English both verbally and in writing. Must be able to lift a minimum of 10 pounds. Intact hearing and sight with or without assistive devices. This position requires long periods of sitting phone use. Repetitive wrist motion.
Requirements
- High School Diploma or GED required
- Ability to work as PRN with varied hours 8a-5p
- Must be able to handle fast paced environment.
- Must have the ability to communicate clearly in English both verbally and in writing.
- Must be able to lift a minimum of 10 pounds.
- Intact hearing and sight with or without assistive devices.
- This position requires long periods of sitting phone use.
- Repetitive wrist motion.
Nice To Haves
- Associates Degree or Bachelor's Degree preferred.
- Experience with Third Party Reimbursement or Utilization Management and knowledge of medical terminology preferred.
- Prefer Payor and authorization/ denial background. M-F 8a-5p
Responsibilities
- Communicates clinical information and negotiates with payors to obtain authorization for appropriate level of care and length of stay.
- Ensures payor and customer satisfaction through effective communication and positive customer service skills at all times.
- Provides prompt feedback regarding payor determinations to appropriate staff.
- Obtains preferred provider and benefit information for home care, DME and post acute services.
- Maintains and enters certification information in appropriate information system.
- Communicates any change in payor information to Outcomes Manager/Care Coordinator.
- Documents changes appropriately.
Benefits
- Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
- Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
- Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program
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What This Job Offers
Job Type
Part-time
Education Level
High school or GED
Number of Employees
11-50 employees
