Payor Specialist

Advocate Health and Hospitals Corporation • Charlotte, NC

4d • Onsite

About The Position

The Payor Specialist will communicate clinical information and negotiate with payors to obtain authorization for the appropriate level of care and length of stay. This role ensures payor and customer satisfaction through effective communication and positive customer service skills. The specialist will provide prompt feedback regarding payor determinations to appropriate staff, obtain preferred provider and benefit information for home care, DME, and post-acute services, and maintain and enter certification information in the appropriate information system. They will also communicate any changes in payor information to the Outcomes Manager/Care Coordinator and document changes appropriately.

Requirements

• High School Diploma or GED required
• 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.

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

• 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

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: High school or GED