Payor Relations Specialist – Rehab Reimbursement & Auth

Ernest Health, Inc.; Toledo (OH); On-site; USD 60,000 - 80,000; Full time

Benefits offered by this job

PPO & HD Medical

FSA/HSA

Dental & Vision

401K

Life insurance

Disability

Job summary

Rehabilitation Hospital of Northwest Ohio in Toledo, Ohio is hiring a Payor Relations Specialist to manage third-party payor authorizations and ensure timely reimbursement for services.

The role partners with insurers and clinical staff to optimize patient outcomes, leveraging knowledge of clinical operations, regulatory standards, and cost of care, while maintaining confidentiality and strong communication.

Qualifications

• Current state RN license preferred.
• Two years recent Utilization Review experience preferred.
• Knowledge of clinical operations, compliance standards, and treatment cost understanding.

Responsibilities

• Obtain and maintain 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 outcomes.

Skills

RN license

Utilization Review experience

Confidentiality

Data entry

Word processing

Email

Record management

Job description

Rehabilitation Hospital of Northwest Ohio in Toledo, Ohio is hiring a Payor Relations Specialist to manage third-party payor authorizations and ensure timely reimbursement for services.

The role partners with insurers and clinical staff to optimize patient outcomes, leveraging knowledge of clinical operations, regulatory standards, and cost of care, while maintaining confidentiality and strong communication.