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Ernest Health · North Texas Rehabilitation Institute · Plano, TX

Payor Relations Specialist

Experience2+ yrs pref.
PostedOct 14
✓You’ll need
Licensure
Current state RN license preferred.
Education
✓Any equivalent combination of education and 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.
Two years recent experience in Utilization Review preferred
+Benefits
PPO and High Deductible Medical Plan optionsFlexible Spending and Health Savings Account options availableDental and Vision coverage401K with employer matchingLife insuranceShort-and-long term disability
Ernest Health
565open roles
18 miPlano to Dallas
All 565 Ernest Health jobs
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✓You’ll need
Licensure
Current state RN license preferred.
Education
✓Any equivalent combination of education and 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.
Two years recent experience in Utilization Review preferred
+Benefits
PPO and High Deductible Medical Plan optionsFlexible Spending and Health Savings Account options availableDental and Vision coverage401K with employer matchingLife insuranceShort-and-long term disability
Ernest Health
565open roles
18 miPlano to Dallas
All 565 Ernest Health jobs
Want the next healthcare job in Texas by email?
Weekly, free, unsubscribe with one click.

Full employer posting

North Texas Rehabilitation Institute We are seeking a full-time Payor Relations Specialist to join our team of passionate patient caregivers! As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs. These programs focus to enhance the employees’ work experience, recognize, and celebrate achievements.

We also encourage employees to share their work experience through “My Ernest Journey” and through our Engagement Survey, where our approach is “You Spoke, We Listened”. These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them. Our hospital offers comprehensive benefits, designed to support your health and financial well-being.

PPO and High Deductible Medical Plan options Flexible Spending and Health Savings Account options available Dental and Vision coverage 401K with employer matching Life insurance Short-and-long term disability Wellness & Work Life Balance: Employee Assistance Program Wellness Program with quarterly wellness challenges with participation incentives Earned Time Off - start accruing vacation time on start date Professional Growth: Continuing education opportunities and reimbursement Qualifications

Current state RN license preferred. Two years recent experience in Utilization Review preferred OR any equivalent combination of education and experience. Additional Qualifications/Skills: 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, 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.

About the role

The Payor Relations Specialist is responsible for obtaining and maintaining 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.