Payor Specialist
About The Position
The Payor Specialist communicates clinical information and negotiates with payors to obtain authorization for appropriate level of care and length of stay. This role ensures payor and customer satisfaction through effective communication and positive customer service skills at all times. The specialist provides prompt feedback regarding payor determinations to appropriate staff, obtains preferred provider and benefit information for home care, DME and post acute services, and maintains and enters certification information in the appropriate information system. Additionally, the Payor Specialist communicates any change in payor information to the Outcomes Manager/Care Coordinator and documents changes appropriately.
Requirements
- Ability to communicate clearly in English both verbally and in writing.
- Ability to lift a minimum of 10 pounds.
- Intact hearing and sight with or without assistive devices.
- Requires long periods of sitting.
- Requires phone use.
- Requires repetitive wrist motion.
- High School Diploma or GED required.
Nice To Haves
- Associates Degree or Bachelor's Degree preferred.
- Experience with Third Party Reimbursement or Utilization Management preferred.
- 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
- Competitive compensation
- Generous retirement offerings
- Programs that invest in your career development
- 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
Career Level
Mid Level
Education Level
High school or GED
