Payor Relations Coordinator

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Job Overview

The position available is for a Payor Relations Coordinator at PromptCare, designed for a highly motivated individual aiming to manage relationships with payors effectively. The role primarily focuses on ensuring compliance with all payor requirements, making it vital for candidates to have excellent communication skills, attention to detail, and a solid grasp of healthcare payor regulations.

Company and Work Environment

PromptCare is known for its commitment to providing necessary services related to in-home respiratory and infusion care. The organization aligns itself with high standards of ethical practice, promoting diversity and inclusion within the workplace. The working hours are set at 40 hours per week, and the position is available in a fully remote capacity, requiring residents from the Central or Eastern Time Zones.

Job Responsibilities

The key responsibilities of the Payor Relations Coordinator include, but are not limited to:

• Managing relationships with payors to ensure compliance with their specific requirements.

• Keeping informed of insurance coverage guidelines and infusion reimbursement terms applicable to a broad range of insurance companies.

• Maintaining knowledge of reimbursement principles and pricing parameters relevant to the organization’s operations.

• Consistently working to become a subject matter expert regarding insurance company reimbursement for home infusion services.

• Communicating effectively and preparing reports for management meetings.

• Ensuring confidentiality concerning company and patient information.

• Participating in completing Medicare, Medicaid, and Payor applications or renewals when necessary.

Required Skills and Qualifications

To be considered for this position, candidates must meet the following prerequisites:

• A Bachelor's degree in Business Administration, Communication, or a related field.

• At least 2+ years of experience in payor relations or healthcare administration is beneficial.

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• An understanding of the value of Managed Care contracts pertinent to the organization’s goals.

• Fundamental understanding of Specialty Infusion, along with knowledge about benefits, authorizations, and billing for infusion services.

• Experience in payor claims and customer service within a similar referral source setting.

• Competency in MS Office suite and potentially CPR+ billing software, though training will be provided.

• A strong work ethic and a desire to support the organization’s Reimbursement and Managed Care Teams.

Physical and Personal Requirements

The physical demands for the job include a requirement to talk and listen continuously, use hands for tasks like handling files, and the ability to lift items weighing up to 50 pounds when needed. Maintaining a neat and professional appearance is essential, along with a courteous demeanor throughout interactions.

Salary and Benefits

While the salary details were not explicitly provided in the text, the position offers a comprehensive range of benefits, including:

• Medical, Dental, and Vision Packages.
• A 401(k) plan (optional).
• Paid time off (PTO) that covers vacation, sick, and personal days, in addition to paid holidays.
• Referral bonuses and a discount ticket program.
• Employee recognition programs to honor staff contributions.

Equal Employment Opportunity

PromptCare upholds a strong commitment to Equal Employment Opportunity (EEO), standing against any discrimination based on characteristics such as race, color, age, national origin, religion, gender, or other classifications below State/Federal/Local regulations. The company emphasizes a respectful workplace where employees are advanced based on merit.

This role not only offers a chance to be a significant part of the healthcare system but affords growth opportunities and a supportive work environment. Those with a passion for improving healthcare outcomes through effective payor relations are strongly encouraged to apply.

This job offer was originally published on himalayas.app