Remote Payor Change Specialist

Accendra Health; Madison (WI); Remote; USD 30,000 - 40,000; Full time

Job summary

Accendra Health is seeking a Payor Change Coordinator to work remotely from home in the United States. The role focuses on patient insurance and payor changes, verifying coverage, obtaining authorizations, and ensuring correct payor and product usage to support accurate reimbursement.

You will interact with patients, payors, branches, and internal teams to resolve issues, ensure timely billing, and maintain compliant processes in a dynamic healthcare environment.

Qualifications

• High school diploma or equivalent.
• At least one year of related work experience.
• At least one year of medical billing experience.
• Familiarity with payor contractual requirements.
• Strong attention to detail and ability to identify and resolve discrepancies.
• Strong verbal and written communication skills.
• Ability to work effectively with patients, payors, branches, and internal teams.
• Basic computer skills, including Microsoft Word, Excel, PowerPoint, Access, MS Project, and Visio.
• English reading, writing, and speaking skills.

Responsibilities

• Process patient insurance and payor changes accurately and efficiently.
• Verify insurance coverage, eligibility requirements, and payor information by phone and online.
• Obtain verbal or written authorization for medical treatment from appropriate sources.
• Ensure the correct product and payor are used for services, equipment, and therapy.
• Verify that the appropriate allowable is recorded in accordance with payor contracts.
• Research and resolve account issues, including gaps between current and former payor requirements and billing documentation.
• Review accounts to ensure open and future invoices are billed correctly.
• Identify and resolve discrepancies in insurance information and account documentation.
• Answer inbound calls from patients regarding updates to their insurance and provide clear information about next steps.
• Coordinate with patients, branches, and referral sources to obtain required testing based on new payor requirements.
• Notify patients and coordinate scheduling for required testing.
• Document account activity accurately in ACIS and other required systems.
• Help ensure payment is guaranteed prior to delivery and revenue is posted appropriately.
• Follow all regulatory requirements, company policies, procedures, and best practices.
• Support additional duties and projects as assigned.

Skills

Attention to detail

Communication skills

Customer service

Problem solving

Multitasking

English proficiency

Team collaboration

Education

High school diploma or equivalent

Tools

Microsoft Word

Excel

PowerPoint

Access

MS Project

Visio

Job description

Accendra Health is seeking a Payor Change Coordinator to work remotely from home in the United States. The role focuses on patient insurance and payor changes, verifying coverage, obtaining authorizations, and ensuring correct payor and product usage to support accurate reimbursement.

You will interact with patients, payors, branches, and internal teams to resolve issues, ensure timely billing, and maintain compliant processes in a dynamic healthcare environment.