Revenue Payor Specialist

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Revenue Payor Specialist

@ VieMed

Essential Job Responsibilities:

• Evaluate new and existing payers/networks and their fee schedule for participation.
• Proactively monitors payor medical policy updates and ensures those are applied to daily processes.
• Collaborates with revenue and credentialing on enrollment of NPI’s for EDI submissions and imports of ERNs into billing software.
• Inputs all new insurance payors contracted/non-contracted in billing software.
• Ensures operations are conducted in a manner that is consistent with overall department protocol, and in compliance with Federal, State, and payer regulations, guidelines, and requirements.
• Maintains a working knowledge of all health information management issues such as HIPAA and all health regulations.
• Reports all concerns or issues directly to Director of Revenue.

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Qualifications:

Experience:

• 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.

Knowledge/Abilities:

• 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.
• Must be proficient in Microsoft Office, including Outlook, Word, and Excel.
• Ability to communicate effectively in writing, over the telephone, and in person.

Work Environment:

• Position is in well-lighted office environment. Occasional evening and weekend work may be required.

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How to Apply:

Apply online at https://www.viemed.com/corporate-careers/. 

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