Payor Escalation Specialist: Complex Issue Resolver

Bronson Healthcare; Kalamazoo (MI); Hybrid; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Payor Escalation Specialist in Kalamazoo, Michigan. This hybrid role involves resolving complex payor issues and managing escalation strategies. Ideal candidates will have a Bachelor's degree in healthcare administration or related fields, alongside strong analytical and communication skills. The position requires collaboration with internal teams and payor representatives to effectively address disputes and ensure contract compliance. Onsite work is expected alongside remote responsibilities.

Qualifications

• Bachelor’s degree in healthcare administration, business, finance, nursing, or related field.
• Experience in managed care operations, payor relations, or revenue cycle leadership.
• Strong understanding of managed care principles and contract interpretation.

Responsibilities

• Act as primary escalation contact for complex payor issues.
• Coordinate escalations with leadership when required.
• Track escalation activity, outcomes, and trends for reporting.

Skills

Analytical skills

Organizational skills

Communication skills

Collaboration

Problem-solving

Education

Bachelor’s degree in healthcare administration or related field

7 years of equivalent experience

Job description

A healthcare organization is seeking a Payor Escalation Specialist in Kalamazoo, Michigan. This hybrid role involves resolving complex payor issues and managing escalation strategies. Ideal candidates will have a Bachelor's degree in healthcare administration or related fields, alongside strong analytical and communication skills. The position requires collaboration with internal teams and payor representatives to effectively address disputes and ensure contract compliance. Onsite work is expected alongside remote responsibilities.