Payor Relations Specialist

Ernest Health, Inc.; Las Cruces (NM); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401K with employer matching

Health, Dental, Vision

Earned Time Off

Job summary

Ernest Health, Inc.'s Rehabilitation Hospital of Southern New Mexico in Las Cruces, NM seeks a Payor Relations Specialist to obtain and maintain third-party authorizations and ensure reimbursement for patient care throughout the stay.

You will collaborate with insurers, managed care organizations, and clinical staff to align treatment needs with coverage, manage costs, and maximize outcomes while upholding confidentiality and regulatory standards.

Qualifications

• Current state RN license preferred.
• Two years' recent Utilization Review experience.
• Equivalents: education plus experience accepted.
• Knowledge of clinical operations and regulatory standards.
• Strong written and verbal communication skills.
• Ability to maintain confidentiality and collaborate with others.

Responsibilities

• Obtain and maintain service authorizations from third-party payors.
• Collaborate with insurers, managed care organizations, and clinical staff.
• Ensure reimbursement for services and maximize patient outcomes.

Skills

RN license

Utilization Review

Confidentiality

Communication

Organizational skills

Time management

Data entry

Record management

Education

Registered Nurse (RN) license

Tools

Microsoft Office

Electronic Health Records (EHR)

Job description

Overview

Join our world-class team of driven, passionate healthcare professionals who are focused on service excellence and providing top quality care!

Join a Team Committed to Restoring Lives

At Rehabilitation Hospital of Southern New Mexico, we are more than a hospital—we are a community of caregivers driven by purpose, compassion, and a shared mission to help patients regain independence after life-changing illness or injury. Located in Las Cruces, NM, our hospital offers state-of-the-art therapy, personalized care plans, and an interdisciplinary team approach that delivers exceptional outcomes. Whether you’re a clinician, therapist, or healthcare leader, you’ll find a rewarding career here where your work truly makes a difference.

Why consider relocating to Las Cruces?

Nestled in the Mesilla Valley against the backdrop of the Organ Mountains, Las Cruces offers a stunning desert landscape, a relaxed pace of life, and a warm, welcoming community. Whether you’re seeking adventure, culture, or a lower cost of living, Las Cruces delivers. 300+ days of sunshine annually—ideal for hiking, biking, and outdoor living.

Easy access to the Organ Mountains-Desert Peaks National Monument, White Sands National Park, and the Rio Grande.

Home to New Mexico State University, bringing energy, education, and innovation to the area.

We are seeking a Payor Relations Specialist to join our team of passionate patient caregivers!

As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs. These programs focus to enhance the employees’ work experience, recognize, and celebrate achievements. We also encourage employees to share their work experience through “My Ernest Journey” and through our Engagement Survey, where our approach is “You Spoke, We Listened”. These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them.

Our hospital offers comprehensive benefits, designed to support your health and financial well-being.

Benefits:

• PPO and High Deductible Medical Plan options
• Flexible Spending and Health Savings Account options available
• Dental and Vision coverage
• 401K with employer matching
• Life insurance
• Short-and-long term disability

Wellness & Work Life Balance:

• Employee Assistance Program
• Wellness Program with quarterly wellness challenges with participation incentives
• Earned Time Off - start accruing vacation time on start date

Professional Growth:

• Continuing education opportunities and reimbursement

Qualifications

Required Skills:

• Current state RN license preferred.
• Two years recent experience in Utilization Review preferred
• OR any equivalent combination of education and experience.

Additional Qualifications/Skills:

• Knowledge of clinical operations and procedures.
• Knowledge of the compliance and regulatory standards governing health plans and patient care.
• Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
• Demonstrates general computer skills including: data entry, word processing, email, and record management.
• Effective organizational and time management skills.
• Effective written and verbal communication skills.
• Ability to maintain proper levels of confidentiality.
• Ability to work closely and professionally with others.
• Ability to maintain quality, safety, and/or infection control standards.

Responsibilities

The Payor Relations Specialist is responsible for obtaining and maintaining service authorizations from third-party payors to ensure reimbursement for services provided, before, throughout, and after a patient stay. They will work directly with insurers, managed care organizations, and clinical staff to ensure the treatment needs of the patients are met, maximizing their overall outcomes and quality of life.