Payor Relations Coordinator

Description

We are seeking a highly motivated Payor Relations Coordinator to join our team. The Payor Relations Coordinator will be responsible for managing relationships with payors and ensuring that our organization is in compliance with all payor requirements. The ideal candidate will have excellent communication skills, be detail-oriented, and have a strong understanding of healthcare payor regulations. If you are a highly motivated individual with a passion for healthcare payor relations, we encourage you to apply for this exciting opportunity. To learn more about our company and services, visit us at PromptCare In-home Respiratory and Infusion

Job Type: Full-time, 40 hours per week, Monday-Friday

Location: Fully Remote, must reside in Central or Eastern Time zone.

Requirements

• Bachelor's degree in Business Administration or Communication, or related field 2 years of experience in payor relations or healthcare administration a plus
• PRC should have a good understanding of the “value” of a Managed Care contract to our organization
• General understanding of Specialty Infusion a plus
• General understanding of benefits/authorization and billing of Infusion services
• Payor Claims experience a plus
• Previous experience with patient admissions, reimbursement billing and collections and customer service in a similar referral source-based practice setting is strongly preferred
• Previous experience working with payor groups
• Must have strong PC skills, especially the MS Office suite. Previous experience with the pharmacy order processing system CPR billing software experience is a major advantage (although training will be provided)
• A strong work ethic and desire to serve our Reimbursement and Managed Care Teams is required
• A strong desire and ability to take care of claims issues while following company procedures is required

Job Responsibilities, included but not limited to:

• Keeps abreast of insurance coverage guidelines and infusion reimbursement terms for the vast array of insurances on the market
• Maintains knowledge of reimbursement principles and pricing parameters at all times
• Ability to provide price quotes when requested as outlined in the SOP
• Consistently works toward becoming a subject matter expert relative to insurance company reimbursement for home infusion services
• Demonstrates ability to communicate effectively and express ideas clearly
• Willingness to prepare department reports to serve as resource during meetings, and update them as needed
• Maintains confidentiality of company and patient information
• Maintains courteous demeanor at all times
• Demonstrates ability to work effectively and maintains expected productivity
• Displays a neat and clean professional appearance at all times
• Demonstrates ability to take all data and present to decision makers when case insurance coverage is in question
• Maintains knowledge of, and compliance to all applicable laws, regulations, and SOPs at all times
• Assist in completing Medicare, Medicaid and Payor applications or renewals when assigned

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. The employee frequently is required to walk; use hands to finger, handle or feel; and reach with hands and arms. Requires the ability to lift files, open filing cabinets and bend or stand as necessary. This position requires the ability to occasionally lift office products and supplies of 20 pounds but no more than 50 pounds.

Benefits & Perks

• Medical, Dental, Vision Package
• 401(k) plan (discretionary)
• PTO - Vacation, Sick and Personal days, and paid holidays
• Referral bonuses & Discount Ticket Program
• Lunch & Learn Programs
• Employee Recognition Program

Equal Employment Opportunity

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.