Reimbursement Payor Analyst

Option Care; Atlanta (GA); On-site; USD 49,000 - 81,000; Full time

Benefits offered by this job

Medical insurance

Paid time off

401K

HSA match

Tuition reimbursement

Flexible spending accounts

MyFlexPay

Job summary

Option Care Health is seeking a payer reimbursement specialist to support training, audits, and system needs across field and corporate teams. You will develop and conduct payer training, manage audit programs, and drive implementation of payer billing software, while maintaining key databases to track referrals, denials and payments.

This role requires solid Excel and Word skills, strong communication, and the ability to work with multiple offices to ensure accurate payer enrollment and ongoing

Qualifications

• High School Diploma with at least 2 years in healthcare intake/admissions or reimbursement.
• Intermediate Excel skills: sums, borders, charts, wrap text, sorts, headers/footers.
• Intermediate Word skills: headers, page breaks, tables and column adjustments.
• Basic PowerPoint skills: slides, text editing, and basic formatting.

Responsibilities

• Create and conduct payer training for field and corporate staff.
• Develop and conduct audit programs; serve as contact for payer audits.
• Implement and train payer billing software/hardware for field and corporate staff.
• Review payer referrals per established approval processes and enroll offices into payer plans.
• Maintain database to quantify payer referrals, denials and payments; support Reimbursement Manager.

Skills

Payer reimbursement knowledge

Education

High School Diploma

Tools

Excel

Word

PowerPoint

Job description

Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career.

Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re‑imagining the infusion care experience for patients, customers and team members. Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.

Job Description Summary

Responsible overall support of payers to include training, audit, system and software needs. Represent the division in payer reimbursement issues to internal and external customers.

Job Description

Job Responsibilities

Responsible for creating and conducting payer training for the field and the corporate employees. Creates and conducts audit programs for field and corporate staff and serves as company contact for Payer audits and issues. Responsible for facilitating payer billing software / hardware program implementation and training for field and corporate staff. Reviews payer referrals per established approval processes. Assists with the enrollment of offices into the various payer plans. Assists individual branch locations with determining payer qualification. Responsible for maintaining database to quantify and trend payer related referral, audit, denial and payment data; develops and maintain required database as directed by the Reimbursement Manager. Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.

No Basic Education and/or Experience Requirements

High School Diploma and at least 2 year of healthcare intake/admissions and/or reimbursement experience.

Basic Qualifications & Interests

Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling). Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns). Basic skill level in Microsoft PowerPoint (for example: inserting, rearranging, hiding and deleting slides, navigating between slides, increasing list level, adding, centering and editing text, changing views, inserting a table or a note, moving objects, printing outline view and/or running a slide show).

Preferred Qualifications & Interests

Previous Infusion Reimbursement experience. At least 1 year of experience applying knowledge of payer reimbursement guidelines.

Due to state pay transparency laws, the full range for the position is below

Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.

Pay Range is $48,500.29-$80,818.80

Benefits

• Medical, Dental, & Vision Insurance
• Paid Time off
• Bonding Time Off
• 401K Retirement Savings Plan with Company Match
• HSA Company Match
• Flexible Spending Accounts
• Tuition Reimbursement
• myFlexPay
• Family Support
• Mental Health Services
• Company Paid Life Insurance
• Award/Recognition Programs

Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.

For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.