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Payor Relations Representative - Remote

Company: ATLAS Healthcare Partners LLC
Location: Phoenix
Posted on: August 8, 2022

Job Description:

Job DescriptionNote: This is a remote job that requires the employee to work from home or a private area.Founded in 2018, Atlas Healthcare Partners specializes in the development and management of ambulatory surgery centers (ASC) in partnership with health systems and physicians. With a successful first partnership with Banner Health, one of the largest nonprofit healthcare systems in the country, Atlas has quickly become one of the fastest-growing ASC management companies in the market. Each person is unique and crucial to that foundation. Our mission is to provide exceptional care and outstanding customer service to every patient, every physician, every time. We believe that five core values define us: Integrity, Culture, Teamwork, Respect, and Results. In short, its a special place to work.ResponsibilitiesPOSITION SUMMARYUnder the direction of the Manager of Payor Relations, the Payor Relations Representative is responsible for managing relationships with payers, Health System partners, CBO and client ASCs. The Representative will provide overall support for the regional contracted inventory including maintaining a shared database with key contract terms, providing accurate and thorough information regarding fee schedules and implementation, payer credentialing and enrollment, products and product changes and contract measures and metrics, including those pertaining to quality and efficiency. Additionally, the Payor Relations Representative will be responsible for the resolution of questions or concerns from/to payers and for internal constituents through operations support and management.ESSENTIAL FUNCTIONSResponsible for communication to Atlas stakeholders of fee schedule updates, contractual requirements, product changes, etc.Internal point of contact and champion for ongoing questions from Atlas stakeholders (CBO, ASCs, Atlas leadership)Lead for facility credentialing and enrollment process with payersMaintenance and coordination of contracting documents and the contracting databaseLead contract implementationLead for payer operational meetings and follow-upKey point of contact (externally) for assigned contractual and client relationshipsEnsure new contract terms (including payment terms) for Payer agreements are successfully communicated within the organization.Ensure that contracts are properly reviewed, executed, and uploaded into the contract database and shared folders.Work cross-functionally across key departments to ensure health plans are compliant with rate loading and other operational terms in accordance with contract effective date(s).Support contracting initiatives in accordance with Atlas business requirements, quality incentive programs and budget requirementsResponsible for engaging client and CBO leadership to resolve issues resulting from payer-related matters to include, but not limited to:Research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors.Facilitates the submission and resolution of payer payment projects on an ongoing basis as directed by the CBO Director or Director of Payor Relations. Manages mass appeals and corrections as necessary with coordination of CBO collections leadership.Builds strong working relationships with assigned business units staff and leadership, health system partners, CBO leaders. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to both internal and external clients.Responds to incoming calls and makes outbound calls as required to resolve payer contract-related issues including billing, payment, fee schedule, payer policies. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers.This is a remote position that requires a quiet workplace and a reliable internet connection.Required SkillsMINIMUM QUALIFICATIONSThis is a remote role and does not require travel or onsiteBS/BA in a relevant field requiredA minimum of three (3) years experience in managed care contracting, fee schedule implementation and reviewing of contracts; or an equivalent combination of education and experience.Strong communication skills with the ability to communicate clearly both verbally and in writing and be able to articulate complex ideas.Self-starter who is accountable and requires minimal direction and supervision; a person who is open to new ideas; and a creative and flexible individual who is comfortable working in a large, complex organization.Possess the personal characteristics of professionalism, credibility, commitment to high standards, innovation, discriminating judgment and accountabilitySolid understanding of fee schedule development and implementation; demonstrated understanding of health care reimbursement methods and strategies.Demonstrated ability to operate collaboratively as part of a team.Must be a highly self-motivated individual with the ability to function in a fast-paced environment with limited supervision and direction.Must be able to handle multiple tasks and priorities.Must be able to effectively translate between health plans, CBO and provider communities.Strong knowledge in the use of common office software applications, presentations, word processing, spreadsheet, and database software as required.

Keywords: ATLAS Healthcare Partners LLC, Phoenix , Payor Relations Representative - Remote, Other , Phoenix, Arizona

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