Payer Relations Manager - Intermountain Health
Augusta, ME
About the Job
Job Description:
This position is responsible for the management of a unit or department to include the management and direction of operations for all department employees.
Details
As a Payer Relations Manager you need to know how to:
Manage the relationship with payers, governmental and non-governmental, to ensure all areas of the health system are appropriately operationalizing payer policies and procedures in order to ensure the reliability and predictability of revenue attributable to those payers.
Develop methods of improving information throughput and end use information acquisition to ensure revenue cycle operations remains compliant with payer policies, and assist in the development of processes to minimize denials, payment delays, and maximize revenue.
Produce and provide regular educational sessions to end users across the health system that orient those operational areas to new payers, and new payer policies that would impact revenue and revenue cycle operations.
- Host and facilitate monthly joint operations committee (JOC) meetings with contracts payers to establish a consistent method of communication and issue identification and resolution.
Oversee the payment variances team and ensure payers are paying the health system as expected to ensure the integrity of revenue expectations. Use intelligence gleaned through the payment variance team to address payer and/or Epic build related issues.
- Identifies trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts.
- Serves as a liaison to internal teams like HB
PB billing, provider strategies, Finance, and payment variance vendors like nThrive to leverage contract terms and mitigate revenue leakage and denials.
- Helps design and implement improvements to established, or proposed, reimbursement process flows in order to maximize potential revenue.
.
Minimum Qualifications
- High School Diploma or Equivalent, required
- Bachelors Degree, preferred
- Three (3) years of experience in revenue cycle insurance follow up or denial management, required
-Three (3) years experience in a complex invoice/billing/reconciliation environment, highly preferred- Extensive knowledge of managed care contract interpretation, highly preferred
Physical Requirements:
Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.
Location:
Peaks Regional Office
Work City:
Broomfield
Work State:
Colorado
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$28.72 - $44.32
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
This position is responsible for the management of a unit or department to include the management and direction of operations for all department employees.
Details
As a Payer Relations Manager you need to know how to:
Manage the relationship with payers, governmental and non-governmental, to ensure all areas of the health system are appropriately operationalizing payer policies and procedures in order to ensure the reliability and predictability of revenue attributable to those payers.
Develop methods of improving information throughput and end use information acquisition to ensure revenue cycle operations remains compliant with payer policies, and assist in the development of processes to minimize denials, payment delays, and maximize revenue.
Produce and provide regular educational sessions to end users across the health system that orient those operational areas to new payers, and new payer policies that would impact revenue and revenue cycle operations.
- Host and facilitate monthly joint operations committee (JOC) meetings with contracts payers to establish a consistent method of communication and issue identification and resolution.
Oversee the payment variances team and ensure payers are paying the health system as expected to ensure the integrity of revenue expectations. Use intelligence gleaned through the payment variance team to address payer and/or Epic build related issues.
- Identifies trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts.
- Serves as a liaison to internal teams like HB
PB billing, provider strategies, Finance, and payment variance vendors like nThrive to leverage contract terms and mitigate revenue leakage and denials.
- Helps design and implement improvements to established, or proposed, reimbursement process flows in order to maximize potential revenue.
.
Minimum Qualifications
- High School Diploma or Equivalent, required
- Bachelors Degree, preferred
- Three (3) years of experience in revenue cycle insurance follow up or denial management, required
-Three (3) years experience in a complex invoice/billing/reconciliation environment, highly preferred- Extensive knowledge of managed care contract interpretation, highly preferred
Physical Requirements:
Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.
Location:
Peaks Regional Office
Work City:
Broomfield
Work State:
Colorado
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$28.72 - $44.32
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
All positions subject to close without notice.
Source : Intermountain Health