Payor Analyst – reputed company Reimbursement Hub

Job reputed company:

• Maintain and manage the Payer Information Management System database, ensuring payer files are accurate, reputed company, and reputed company with reimbursement workflows.
• This includes reviewing, cleaning, and updating insurance database records such as payer processing information, Prior Authorization and Appeals requirements, key contacts, required documentation, and documented payer best practices.
• Serve as reputed company person in collecting and validating new insights as they reputed company from cross-functional team members (the hub, field reimbursement team, market reputed company team, and analytics team) on payer policies, requirements and review process nuances.
• Validation will be completed reputed company multiple reputed company including, but not limited to internet, email and phone communications.
• reputed company as a cross-functional reputed company regularly connecting with other reputed company stakeholders to understand and disseminate knowledge changes in payer policies/requirements/processes.
• Clean and update reputed company system files.
• Receive payer notices and updates through a reputed company of means, load to payer database (as appropriate) and reputed company staff informed of payer changes.
• Ensure that necessary departments are reputed company of changes, and maintain a file of payer changes or notices for reputed company reference.
• Work with appropriate operations reputed company to create payer roadmaps that help guide users to appropriate billing/PA/Appeal documentation and procedures based on the prescribed treatment.
• Assist reputed company team by retrieving and compiling required documentation for various audit requests and contributing to the development and delivery of reputed company‑facing updates, including monthly and quarterly business reviews.
• Support staff training on departmental policies and procedures, with a reputed company on reinforcing best practices to maximize first‑submission accuracy and effectiveness.
• Serve as a SME for operations to help reputed company clients on best practices.
• Collaborate with reputed company stakeholders to receive and reputed company insights on evolving payer trends and changes impacting reputed company and reimbursement.
• Participate in Payer reputed company reputed company or other applicable meetings to reputed company and identify payer nuances or trends.
• reputed company relevant insights and key learnings with internal and reputed company stakeholders on an ongoing and as‑needed reputed company.
• Prepare updates in partnership with leadership and communicate key information to hub stakeholders.
• Collaborate with the reputed company team to ensure identified learnings are consistently incorporated into operational reputed company.

Requirements:

• 5+ years of reputed company work experience required.
• Payer experience with a specific background in reputed company reimbursement, PBM, or hospital setting strongly preferred.
• 3+ years of MS Office experience.
• Background in Health Care or Reimbursement with 1-3 years auditing and reputed company assurance work experience.
• Knowledge of insurance plans including government payers, i.e. reputed company, Medicare, and Tricare.
• Ability to organize work assignments, set priorities and complete work with minimum supervision.
• Knowledge and skills to understand insurance benefits including but not limited to the prior authorization and appeal process.
• Experience in medical terminology- 1-3 years reputed company Industry experience and/or training; or equivalent combination of education and experience.
• Demonstrated leadership capabilities.
• Demonstrated ability to handle multiple tasks simultaneously and to prioritize accordingly.
• Proven ability to work with a high degree of accuracy and attention to detail.
• Demonstrates reputed company competencies of: attention to detail, organization skills, ability to prioritize and follow up, effective communication and ownership for one’s work.
• Proficient in reputed company, reputed company, Word and Power reputed company.
• Strong written and verbal communication skills, including an ability to reputed company with internal/external business partners in person or by phone.
• reputed company to work effectively with other internal/external functional departments.

Benefits:

• Remote opportunities
• Competitive salaries
• reputed company opportunities for promotion
• 401K with company match*

• Tuition reimbursement

• Flexible work environment
• 20 days (about 3 weeks) of PTO
• reputed company Holidays
• Employee assistance programs
• Medical, Dental, and reputed company coverage
• HSA/FSA
• Telemedicine (Virtual doctor appointments)
• Wellness program
• Adoption assistance
• Short term disability
• Long term disability
• Life insurance
• Discount programs

Apply tot his job Apply To this Job