Payor Relations Specialist

2 weeks ago

Rancho Mirage, United States Ernest Health Full time

Overview:
At** Rehabilitation Hospital of Southern California,** we consider ourselves patient-centered and family-friendly. We truly consider it an honor to be able to help members of our community as they recover from serious injuries, illnesses, and debilitating medical conditions. Vibra Rehabilitation Hospital of Rancho Mirage has earned The Joint Commission’s Gold Seal of Approval® for Hospital Accreditation by demonstrating continuous compliance with performance standards. The Gold Seal is a symbol of quality that reflects our commitment to providing safe and quality patient care.

**We are seeking a Payor Relations Specialist to join our team of passionate patient caregivers**
- As a participating hospital of Ernest Health, our patients are family. Healthcare is constantly evolving, and our growing organization is devoted to ensuring that each person in our care feels safe. Our world-class team of driven, passionate healthcare professionals is always focused on service excellence and providing top quality care at the bedside._

Employees are our priority. We are passionate about patient care and consider it a privilege to be able to provide services to patients and their family members. Ernest Health provides a variety of benefits to all our employees including:

- PPO and High Deductible Medical Plan options
- FSA and HSA (with employer matching) options available
- Dental and Vision coverage
- 401K with employer matching
- Life insurance
- Short-and-long term disability
- Pet insurance
- Employee Assistance Program
- Wellness Program
- Tuition and Continuing Education reimbursement
- Earned Time Off

Full-Time and Part-Time Clinical positions are also eligible for:

- Clinical Career Ladder levels
- Nursing Preceptor Programs
- PCT Career Path levels
- CRRN or CCRN Certification Pay

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.
- 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.

**We're located in the following states**:

- Arizona
- California
- Colorado
- Idaho
- Indiana
- Montana
- New Mexico
- Ohio
- South Carolina
- Texas
- Utah
- Wisconsin
- Wyoming

**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.

Posted Total Compensation : The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to, skill sets, experience, education and training, licensure and certifications, and other business and organizational needs. It’s not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $90k - $110k Minimum Salary: USD $90,000.00/Yr. Maximum Salary: USD $114,780.00/Yr.

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