Payor Relations Representative

Description

Job Title:  Payor Relations Representative

Job Type:  Full-Time

Location: Hybrid, requiring 2 to 3 days in the office 

Providence Anesthesiology Associates is seeking a Payor Relations Representative to join our team. The ideal candidate will be responsible for reviewing claims and EOBs for accuracy, ensuring payments and adjustments align with patient accounts. The Payor Relations Representative will also be responsible for assisting patients with billing inquiries, correcting adjustments, submitting arbitration or underpayment details via online forms, and managing out-of-network claim reviews.

Responsibilities:

•  Patient Support: Answer inbound calls from out-of-network patients, assist with account inquiries, and provide cost estimates for scheduled procedures.
• Account Management: Assess and maintain patient accounts, follow up on detailed reviews, and process credit card transactions.
• Claims Analysis: Review out-of-network claims for compliance with the No Surprise Billing Act and identify under-payments or discrepancies.
• Data Handling: Compile and submit claims data via Excel and online portals for IDR, and attach documentation to patient files.
• Insurance Coordination: Communicate with carriers regarding under-paid claims, learn in-network contract terms, and submit appeals/reconsiderations.
• Eligibility Verification: Verify patient insurance coverage and adjust accounts based on Explanation of Benefits (EOBs).
• Compliance and Miscellaneous: Ensure HIPAA compliance and perform additional duties as assigned within the role’s scope.

Requirements:

• High School Diploma or equivalent required. Associates degree or medical billing education preferred. 
• One (1) year of customer service experience in a medical billing environment is required. One (1) year of Accounts Receivable and the ability to understand and analyze complex AR resolutions is highly preferred. 
• Excellent organizational and time management skills
• Effective communication skills, both written and verbal
• Familiarity with in-network provider contracts and claim processing
• Ability to work independently and as part of a team
• Proficient in Microsoft Office and other medical billing software systems

We are an equal opportunity employer and welcome all qualified candidates to apply. We are committed to creating a diverse and inclusive workplace and do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other legally protected status.  

If you are a highly motivated individual with a passion for healthcare and a desire to make a difference, we encourage you to apply for this exciting opportunity.

Requirements

About Providence Anesthesiology Associates Headquartered in Charlotte, North Carolina, Providence Anesthesiology Associates (PAA) is an independent physician owned practice compromised of over 140 anesthesiologists. Founded in 1991, PAA provides anesthesia and perioperative care at numerous healthcare facilities throughout North and South Carolina, serving more than 232,000 patients annually.

Why work for PAA?

PAA continues to experience impressive growth and success. Our anesthesiologists are among the most elite in their field.

Our physicians are committed to providing the best culture and experience to their employees. Awarded one of the Top Workplaces in 2021 - 2023, PAA’s core values include commitment, accountability, performance, integrity, transparency, adaptability, and leadership. We do what’s right and don’t compromise.

What’s in it for you?

• Strong workplace culture. We care about each other as people. We build relationships and connections beyond the time spent on the job. We offer a supportive, highly team-oriented work environment.
• We provide competitive total rewards including salary, benefits – Day 1, retirement, profit sharing, life insurance, paid time off, holidays, education reimbursement, employee recognition for birthdays and anniversaries, fun team building events, and more.
• We want you to succeed and our employer to employee relationship is proven to help you reach your goals and the goals of PAA.