Payor Relations Specialist - Ernest Health : Job Details

At Advanced Care Hospital of Montana, we provide critical care services to patients recovering from serious illnesses or injuries. Often our patients require additional critical care services for medically complex conditions such as trauma, infectious diseases, wound healing, cardiovascular disease, stroke, amputation and ventilator weaning. At our 40-bed hospital, we provide specialized treatment throughout Montana, Wyoming, and Western South Dakota.

We are seeking a Payor Relations Specialist to join our team of passionate patient caregivers!

As a participating hospital of Ernest Health, our patients are family. Healthcare is constantly evolving, and our growing organization is devoted to ensuring that each person in our care feels safe. Our world-class team of driven, passionate healthcare professionals is always focused on service excellence and providing top quality care at the bedside.

Employees are our priority. We are passionate about patient care and consider it a privilege to be able to provide services to patients and their family members. Ernest Health provides a variety of benefits to all our employees including:

• PPO and High Deductible Medical Plan options
• FSA and HSA (with employer matching) options available
• Dental and Vision coverage
• 401K with employer matching
• Life insurance
• Short-and-long term disability
• Pet insurance
• Employee Assistance Program
• Wellness Program
• Tuition and Continuing Education reimbursement
• Earned Time Off

Full-Time and Part-Time Clinical positions are also eligible for:

• Clinical Career Ladder levels
• Nursing Preceptor Programs
• PCT Career Path levels
• CRRN or CCRN Certification Pay

Required Skills:

• 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.

Are you interested in relocating? Check out our other opportunities:

We're located in the following states:

• Arizona
• California
• Colorado
• Idaho
• Indiana
• Montana
• New Mexico
• Ohio
• South Carolina
• Texas
• Utah
• Wisconsin
• Wyoming

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.