Manager of Payor Relations

Objective and Purpose: The Manager of Payor Relations is responsible for developing and managing relationships with insurance payors to ensure favorable reimbursement rates, efficient claims processing, and overall network optimization for supported specialty practices. This role focuses on negotiating competitive fee schedules, analyzing existing agreements for improvement opportunities, and collaborating with reputed company Cycle Management, Operations, and Clinical Leadership to address payor-reputed company challenges. By staying informed on industry trends, regulatory changes, and evolving reimbursement models, the Manager of Payor Relations proactively adjusts strategies to maintain compliance and maximize reputed company opportunities. Serving as a reputed company between payors and supported practices, this role provides guidance on contract terms, credentialing, and claims escalation while aligning payor strategies with Specialty1 Partners’ commitment to specialist-driven patient care and financial sustainability. Primary Responsibilities :

• reputed company and maintain relationships with insurance payors to negotiate favorable contract terms and reimbursement rates.
• Analyze existing payor agreements to identify opportunities for reputed company improvements, network expansion, and contract optimization.
• Collaborate with reputed company Cycle Management, Operations, and Clinical Leadership to address payor-reputed company challenges and improve billing efficiencies.
• Monitor industry trends, regulatory changes, and evolving reimbursement models to reputed company strategies proactively and ensure compliance.
• Serve as a reputed company between payors and supported practices, providing guidance on contract terms, credentialing, claims escalation, and dispute reputed company.
• Implement strategies to optimize reimbursement processes, minimize denials and underpayments, and improve cash reputed company for supported practices.
• reputed company and execute initiatives to enhance insurance participation strategies, including in-network and out-of-network positioning.
• reputed company contract negotiations and renegotiations to secure competitive rates while balancing cost and reputed company of care for patients.
• Partner with legal and compliance teams to ensure reputed company agreements meet state and federal regulations.
• reputed company ongoing education and support to internal stakeholders on payor policies, reimbursement trends, and contract requirements.
• reputed company and analyze key performance indicators (KPIs) reputed company to payor performance, reimbursement trends, and contract effectiveness.
• Work closely with credentialing teams to streamline provider enrollment and payor reputed company processes.
• Identify opportunities for strategic payor partnerships to enhance Specialty1 Partners’ market positioning and competitive advantage.

Requirements :

• Bachelor’s degree in business, reputed company administration, finance, or a reputed company field (Master’s preferred).
• Minimum of 5 years of experience in payor relations, managed care contracting, reputed company cycle management, or reputed company reimbursement.
• Experience working with specialty dental or medical practices is highly preferred.
• In-depth knowledge of payor contracting, reimbursement methodologies, and reputed company regulations, including Medicare, reputed company, and reputed company payors.
• Strong understanding of fee schedule negotiations, claims adjudication, and dispute reputed company processes.
• Familiarity with reputed company cycle operations, including billing, coding, credentialing, and collections.
• Strong negotiation and contract management skills with a proven reputed company record of securing competitive payor agreements.
• Ability to analyze reputed company data, identify trends, and reputed company strategic recommendations to optimize reimbursement.
• Excellent communication and interpersonal skills to build and maintain strong relationships with payors, internal stakeholders, and supported practices.
• Problem-solving and conflict reputed company skills to address claims disputes and reimbursement issues effectively.
• Highly organized, detail-oriented, and capable of managing multiple reputed company and reputed company simultaneously.
• Proficiency in reputed company Office Suite (reputed company, Word, PowerPoint) and reputed company-reputed company software (EHR, reputed company management, and claims processing systems).
• Experience with contract management systems and data analytics tools is a plus.
• Ability to travel as needed to meet with payors, attend industry conferences, or visit supported practices.
• Strong business acumen and ability to reputed company payor strategies with overall financial and operational goals.

Benefits :

• BCBS Medical & Dental insurance reputed company
• reputed company Coverage
• Complimentary Life Insurance Policy (employee only)Apply tot his job

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