[Hiring] Payer Profile Administrator @Numotion

Role Description

This role requires initiative and the ability to work in a fast-paced, diverse, and dynamic environment. The Payer Profile Administrator will manage the company Payer Profiles within the operating system, update fee schedules, and audit payer documentation for compliance. This position will act as the support for escalated issues, researching accounts receivable/collection efforts for resolution.

• Manage Payer Profiles in Operating System to ensure Payer information, Payer Requirements, and Fee schedule are in alignment according to contracts.
• Partner with leadership and Contract Management to develop Payer strategies.
• Investigate Payer concerns brought by Operations and Billing to ensure Payer Profile is accurate as well as make appropriate changes.
• Resolve discrepancies in partnership with Contracting and/or the payer when they are not managing to the contract.
• Accountable to make decisions on Payer Profile set-up that affect how revenue is booked in the operating system based on knowledge and understanding of documentation and medical coding.
• Maintain insurance Fee Schedules in Operating System.
• Interpret insurer documentation requirements to ensure accuracy for bookmarking of prefill forms.
• Research and resolve escalated and complex payer issues in partnership with Accounts Receivable/Collections as well as provide strategies.
• Develop and distribute payer communications on new policy and changes to policies across the organization.
• Responsible for reviewing Payer websites for changes and updating as appropriate that may affect the current payer profile information and configuration to ensure accuracy and operations.
• Complete routine file audits for payer documentation compliance.

Qualifications

• 5-10 years working with insurers in various capacities such as but not limited to: pursuing and obtaining prior authorization for procedures or services provided, billing or collections.
• Bachelor degree or applicable work experience.
• Data entry in Operating system, WORD, Excel.
• Sound communication abilities.
• Ability to set priorities and work under pressure.

Benefits

• Competitive compensation packages.
• Medical, dental, and vision insurance.
• Short-term and long-term disability.
• 401k.
• Life insurance.