Revenue Payor Specialist
1 week ago
VieMed is seeking a highly skilled Revenue Payor Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for evaluating new and existing payers/networks and their fee schedules for participation.
Key Responsibilities:- Evaluate new and existing payers/networks and their fee schedules for participation.
- Monitor payor medical policy updates and ensure they are applied to daily processes.
- Collaborate with revenue and credentialing teams on enrollment of NPIs for EDI submissions and imports of ERNs into billing software.
- Input all new insurance payors contracted/non-contracted in billing software.
- Ensure operations are conducted in a manner consistent with overall department protocol and in compliance with Federal, State, and payer regulations, guidelines, and requirements.
- Maintain a working knowledge of all health information management issues, including HIPAA and health regulations.
- Report all concerns or issues directly to the Director of Revenue.
- Minimum of four (5) years Medical Insurance/Healthcare Billing and Collections experience in a medical practice or health system, with a deep understanding of insurance medical/fee schedule policies and regulations experience preferred.
- Strong knowledge of payor reimbursement and medical policies.
- Strong Excel, analytical, problem-solving, and communication skills.
- Detailed-oriented with the ability to work independently and meet deadlines.
- Working knowledge of CPT and ICD9 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal processes.
- Up-to-date with health information technologies and applications.
- Proficient in Microsoft Office, including Outlook, Word, and Excel.
- Ability to communicate effectively in writing, over the telephone, and in person.
- Position is in a well-lighted office environment. Occasional evening and weekend work may be required.
VieMed is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. We are committed to providing a work environment that is free from discrimination and harassment. We are an affirmative action employer and provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, national origin, age, disability, or any other protected characteristic.
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