Payor Relations Specialist: Reimbursement & Authorization

Ernest Health, Inc.; Denver, Northern (CO, KY); Hybrid; USD 54,000 - 68,000; Full time

Benefits offered by this job

Medical plans

HSA/FSAs

Dental & Vision

401K match

Life insurance

Disability

Job summary

Ernest Health, Inc. is seeking a Payor Relations Specialist in Denver, CO, to manage authorizations with third‑party payors and support patient care financials. The role collaborates with insurers, MCOs, and clinical staff to ensure timely reimbursement and optimal patient outcomes.

We offer comprehensive benefits and growth opportunities through continuing education and wellness programs as part of our employee experience.

Qualifications

• 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.
• They will work directly with insurers, managed care organizations, and clinical staff to ensure the treatment needs of the patients are met, maximizing outcomes and quality of life.

Skills

RN license

Utilization Review

Education/Experience mix

Job description

Ernest Health, Inc. is seeking a Payor Relations Specialist in Denver, CO, to manage authorizations with third‑party payors and support patient care financials. The role collaborates with insurers, MCOs, and clinical staff to ensure timely reimbursement and optimal patient outcomes.

We offer comprehensive benefits and growth opportunities through continuing education and wellness programs as part of our employee experience.