Senior Payer Manager - Managed Care (Hybrid/Remote)

adventhealth; Orlando (FL); Hybrid; USD 60,000 - 112,000; Full time

Job summary

AdventHealth in Maitland, Florida is seeking a seasoned Payer Manager to optimize revenue cycle processes and support government contracts. You will align with Finance and Revenue Cycle teams, manage payer data, and drive improvements to reimbursement accuracy.

The role requires extensive experience in managed care, strong analytics, and proficiency with Epic RHBC; remote options may be available for local candidates.

Qualifications

• Associates degree required; Bachelor's preferred.
• 5+ years in managed care, hospital revenue cycle, or payer/provider relations.
• Epic Resolute Hospital Billing Charging (EPIC RHBC) certification preferred.

Responsibilities

• Stays updated on regulatory changes to ensure compliance with industry standards.
• Manages payer information to ensure accurate and timely reimbursement.
• Addresses systematic issues to improve operational efficiency.
• Details audit and error findings to support corrective actions.
• Develops systems to enhance operational capabilities and efficiency.
• Manages service tickets to ensure timely resolution of issues.
• Troubleshoots issues to minimize disruptions and maintain system performance.
• Implements contracts to ensure compliance with terms and conditions.
• Updates government and non-contracted rates quarterly, annually, and interim as needed.
• Prepares high-level analytic information for Revenue Cycle leadership.
• Collaborates with Contract Administration, Revenue Cycle stakeholders, and Finance on government/state contracts.
• Supports Managed Care Contract Administration and Central Denials across departments.
• Mentors staff to enhance skills and knowledge.
• Conducts system audits to identify improvements.

Skills

Microsoft Office

Analytical

Organized

Data summarization

Project leadership

Attention to detail

Multi-tasking

Interpersonal communication

Education

Associates

Bachelor's

Tools

EPIC RHBC

Job description

AdventHealth in Maitland, Florida is seeking a seasoned Payer Manager to optimize revenue cycle processes and support government contracts. You will align with Finance and Revenue Cycle teams, manage payer data, and drive improvements to reimbursement accuracy.

The role requires extensive experience in managed care, strong analytics, and proficiency with Epic RHBC; remote options may be available for local candidates.