Reimbursement-Focused Payor Relations Specialist

Ernest Health, Inc.; Bloomington (IN); On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

401K with employer matching

Life insurance

Short- and long term disability

Dental and Vision coverage

PPO and HDHP options

FSA / HSA options

Job summary

Bloomington Regional Rehabilitation Hospital in Bloomington, Indiana, seeks a Payor Relations Specialist (Clinical) to secure and maintain payer authorizations, collaborating with insurers and clinical staff to optimize patient outcomes and reimbursement.

The role emphasizes clinical operations knowledge, regulatory compliance, and strong communication, confidentiality, and organizational skills within Ernest Health’s network.

Qualifications

• Current state RN license preferred.
• Two years' recent Utilization Review experience preferred.
• Equivalent education and experience may substitute.

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 their overall outcomes and quality of life.

Skills

Utilization Review

Clinical operations

Compliance standards

Communication skills

Time management

Data entry

Teamwork

Infection control

Confidentiality

Education

RN license

Job description

Bloomington Regional Rehabilitation Hospital in Bloomington, Indiana, seeks a Payor Relations Specialist (Clinical) to secure and maintain payer authorizations, collaborating with insurers and clinical staff to optimize patient outcomes and reimbursement.

The role emphasizes clinical operations knowledge, regulatory compliance, and strong communication, confidentiality, and organizational skills within Ernest Health’s network.