Children’s Cardiology, a subsidiary of Children’s Healthcare of Atlanta, is comprised of more than 50 pediatric cardiologists providing comprehensive services for patients from before birth to age 21 who have acquired or congenital heart disease. The Manager, Payer Operations is responsible for maintaining collaborative relationships with third-party payers, developing project plans and strategies for assigned payers, and acting as a resource for complex authorizations, claims or denials.

Minimum Qualifications

• Bachelor’s degree in Business, Healthcare Administration or related field, or equivalent experience required.
• Minimum 5 years of professional experience in Revenue Cycle, business operations or other relevant work experience.
• Demonstrated knowledge of medical terminology, ICD-10 and CPT.
• Strong computer, typing and writing skills.
• Proficient in Microsoft Office Suite.
• Preferred experience with Epic.
• Effective oral and written communication.
• Demonstrated ability to effectively communicate with different level managers.
• Must possess a high level of confidentiality, analytical and problem-solving skills.
• Strong attention to detail, organizational skills and follow-through discipline.
• Ability to prioritize and handle multiple tasks and projects concurrently.

Essential Duties and Responsibilities

• Build and maintain strong collaborative relationships with both third-party payers and internal stakeholders.
• Develop and implement strategies to administer company contracts with third-party payers in collaboration with the Director, while preserving Children’s Cardiology contractual rights.
• Manage third-party payer operations meetings, monthly claims calls and ad-hoc meetings in coordination with Revenue Cycle Managers and Director to ensure operational issues are being addressed efficiently.
• Communicate identified payer operational issues to internal and external parties, acting as mediator and troubleshooter in disputes with third-party payers.
• Review third-party payer correspondence for changes in policies and requirements that impact operational and clinical processes and informing departments of these changes.
• Serve as a resource for internal stakeholders to troubleshoot complex authorization, claim or denial issues.
• Develop, track and maintain project plans and strategies for assigned third-party payers, identifying possible solutions to overcome barriers to internal stakeholders and leadership.
• Perform other projects and duties as assigned.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status or any protected category.

As a part of the recruiting and new hire process with Children’s Cardiology, employment history will be verified and ANY false statements, omissions or misrepresentations of your application or resume will result in not being hired by the company.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Education:

• Bachelor's (Preferred)

Experience:

• Epic/EMR: 1 year (Preferred)
• Revenue Cycle: 5 years (Preferred)

Ability to Relocate:

• Atlanta, GA 30341: Relocate before starting work (Required)

Work Location: Hybrid remote in Atlanta, GA 30341