At Independence Physician Management (IPM a subsidiary of UHS Inc.) we're looking for exceptional people who share our vision and values, who share our focus on hard work, enthusiasm, teamwork, loyalty, trust and cooperation. We've embraced these traits and built a team of employees who consistently work to achieve the highest level of service excellence. People are our most valuable resource at IPM as we are committed to providing high quality acute care and behavioral health services to residents of the communities we serve. We are equally committed to offering our employees unlimited opportunity in an environment that encourages professional development.
The Payer Relations Representative is responsible to act as the Central Billing Operation (CBO) liaison to the provider representatives of IPM contracted payers. Coordinates regularly scheduled meetings with IPM contracted payers and CBO Leadership to resolve customer service issues, payer rejections, denial trends and other pertinent issues having a negative impact on revenue cycle. Maintains expanded knowledge base of IPM contracted payer/product lines, claim requirements, electronic support tools (e.g. web link, ERA), payer policies, payer process/procedure to support CBO end user functions/tasks. Effects system and process/workflow updates with the timely review and distribution of contracted payer updates, bulletins and newsletters. Ensures that updates have been completed accurately and timely to drive positive revenue cycle results. Provides direction, based on contracted payer communications, to the appropriate CBO departments, on items that require action to minimize interruption in revenue cycle operations.
Cultivates positive and productive relationships with IPM contracted payer provider representatives to ensure an expanded knowledge base of payer/product lines, electronic support services, and payer policies and billing requirements to support CBO end user functions/tasks.
Develops communication policies for timely education to CBO Leadership/Staff on new IPM contracted payers to include product line, referral processes, co-pay collection, policy and billing requirements, etc.Provides direction, based on contracted payer communications, to the appropriate CBO departments, on items that require action to minimize interruption in revenue cycle operations.
Collaborates with CBO Leadership, Market Managers, and Practice Administrators/Managers to identify payer specific root causes that are negatively impacting revenue cycle.Identifies opportunities for payer-specific training and/or education and provide customer-focused, needs-based education to influence enhanced performance improvement and results.Works closely with IPM Managed Care contracting resources to communicate payor issues and work toward resolution
Maintains expanded knowledge base of IPM contracted payer/product lines, payer policy and billing requirements, electronic support tools (e.g. web link, ERA), payer policies, payer process/procedure to support CBO end user functions/tasks.
Acts as the CBO Liaison to provider representatives for contracted payers.Serves as a point of escalation for CBO Leadership to resolve outstanding issues with positive financial impact
Demonstrates excellent initiative and judgement. Works independently applying effective approaches to task prioritization, time management, meeting deadlines, and customer service.
Performs other duties as assigned.
High School Diploma/GED required. Bachelor s degree preferred.
Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance, call center or equivalent operations work environment. Experience with Cerner applications highly desirable.
Healthcare (professional) billing, knowledge of CPT/ICD-10 coding, claim submission requirements and other related industry terminology and practical use. Thorough understanding of the revenue cycle and how the various components work together.
Excellent writing and verbal skills. Ability to multi-task. Strong attention to detail along with solid organizational skills required. Excellent interpersonal skills required. Proven ability to convey complex or confusing processes in an easily understood manner. Excellent ability to compile training material that looks professional, if easily understandable and free of typos and industry jargon. Proven ability to work with Microsoft Word, Excel and PowerPoint. Strong computer literacy skills required.
If you meet the above requirements and are looking for a rewarding career, please take a moment to share your background with us by applying online. Independence Physician Management offers competitive compensation commensurate with experience and benefit programs including medical, dental, life insurance, and 401(k).
Independence Physician Management is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at IPM via email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of Independence Physician Management. No fee will be paid in the event the candidate is hired as a result of the referral or through other means.