What are the responsibilities and job description for the Payor Relations Specialist position at Ernest Health?
At Summa Rehabilitation Hospital, we are passionate about patient care! At our 60-bed hospital, we provide inpatient rehabilitative services to our patients who are often recovering from disabilities caused by injuries, illnesses, or chronic medical conditions.
We are seeking a Payor Relations Specialist to join our team of passionate patient caregivers!
As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs. These programs focus to enhance the employees’ work experience, recognize, and celebrate achievements. We also encourage employees to share their work experience through “My Ernest Journey” and through our Engagement Survey, where our approach is “You Spoke, We Listened”. These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them.
Our hospital offers comprehensive benefits, designed to support your health and financial well-being.
Benefits:
- Medical, Dental, Vision plan coverage
- Flexible Spending and Health Savings Account options available
- Pet Insurance
- 401K with employer matching
- Life insurance
- Short-and-long term disability
Wellness & Work Life Balance:
- Employee Assistance Program
- Wellness Program with quarterly wellness challenges with participation incentives
- Earned Time Off - start accruing vacation time on start date
Professional Growth:
- Continuing education opportunities and reimbursement
Qualifications
Required Skills:
- Current state RN license preferred.
- Two years recent experience in Utilization Review preferred
- OR any equivalent combination of education and experience.
Additional Qualifications/Skills:
- Knowledge of clinical operations and procedures.
- Knowledge of the compliance and regulatory standards governing health plans and patient care.
- Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
- Demonstrates general computer skills including: data entry, word processing, email, and record management.
- Effective organizational and time management skills.
- Effective written and verbal communication skills.
- Ability to maintain proper levels of confidentiality.
- Ability to work closely and professionally with others.
- Ability to maintain quality, safety, and/or infection control standards.
Responsibilities
The Payor Relations Specialist is responsible for obtaining and maintaining service authorizations from third-party payors to ensure reimbursement for services provided, before, throughout, and after a patient stay. They will work directly with insurers, managed care organizations, and clinical staff to ensure the treatment needs of the patients are met, maximizing their overall outcomes and quality of life.