Payer Specialist

The Payer Specialist will report to the Revenue Cycle Business Partner and is an integral member of the Revenue Cycle Team. This position allows for remote work. 

• →Ensure timely billing for all payers within region, including secondary billing. 

• →Maintain accurate notes and communication in the patient’s ledger/chart. 

• →Ensure accuracy of insurance information and verification, working with PC if any discrepancies.  

• →Collaborate with all parties to maintain denial prevention methods.   

• →Follow up on Accounts Receivable by insurance, collecting required information to have claim processed or appealed.  

• →Communicate directly with payers via phone, email, or any other means necessary. 

• →Manage third-party vendor to successfully have claims paid. 

• →Actively engages in the research, setup, preparation, and testing of new payer information regarding contract details, reimbursement terms, claim form requirements, billing & collections requirements, timely filing requirements, and any other information.  

• →Track and resolve discrepancies, based on partial payments and contracts. 

• →Assist PCs and patients with billing related questions. 

• →Work one on one with users in all areas of the company to resolve any issues that may arise.  

• →Prepare reports as needed. 

• →Performs other duties as assigned. 

• A high school diploma or GED equivalent required. 

• A minimum of three years’ experience in all facets of healthcare payer environment 

• Computer skills using Microsoft Outlook, Word, Excel and Access. 

• Excellent oral communication skills and phone presence. 

• Understanding of quality customer service. 

• Demonstrated ability to prioritize tasks and work with a sense of urgency. 

• Experience with a variety of EMR systems, Raintree experience is a plus.  

• Exceeding Expectations: Deliver best-in-class care and witness exceptional patient outcomes.   

• Empowering Values: Live by values that prioritize teamwork, growth, and serving others.