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Payor Relations Coordinator

Payor Relations Coordinator

Hospital for Special SurgeryNew York, NY, US
30+ days ago
Job type
  • Full-time
Job description

Job Opportunity At Hospital For Special Surgery

How you move is why we're here. Now more than ever, our guiding principles are helping us in our search for exceptional talent - candidates who align with our unique workplace culture and who want to maximize the abundant opportunities for growth and success. If this describes you then let's talk! HSS is consistently among the top-ranked hospitals for orthopedics and rheumatology by U.S. News & World Report. As a recipient of the Magnet Award for Nursing Excellence, HSS was the first hospital in New York City to receive the distinguished designation. Whether you are early in your career or an expert in your field, you will find HSS an innovative, supportive and inclusive environment.

Working with colleagues who love what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.

Emp Status : Regular Full Time

Work Shift : Not specified

Compensation Range : $58,000.00 - $88,000.00. In addition, this position will be eligible for additional benefits consistent with the role. The salary of the finalist selected for this role will be determined based on various factors, including but not limited to : scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. The hiring range listed is a good faith determination of potential compensation at the time of this job advertisement and may be modified in the future.

What You Will Be Doing

Reporting to the AVP Physician Contracting, Contract Operations and Enrollment, alongside the Senior Director of Contract Operations, the Payor Relations Coordinator plays a crucial role that demands a unique set of skills to ensure seamless interactions with Insurance Payors, PHO physician members, facility billing departments, and other HSS stakeholders (including Patient Financial Services, Central Billing Office, Medical Staff, external billing companies, etc.).

Responsibilities :

  • Ensures compliance of managed care companies and payment rules within negotiated contracts.
  • Collaborates closely within the Contract Operations team, external billers, Central Billing Office (PCBO), Patient Financial Services, to identify trends and opportunities in outstanding Accounts Receivables.
  • Acts as the liaison for Contracting and Contract Operations issues between physician offices, business offices, and Insurance Payors.
  • Manages trackers, agendas / meeting minutes, and follows up on open issues from identification to resolution.
  • Coordinates the education of physician offices through updates from insurance carriers.
  • Assists in the negotiation and maintenance of physician managed care contracts by capturing and managing pain points as identified through relationship management.
  • Responsible for the assignment, dissemination, and administrative management of inquiries received through the PHO inbox.
  • Assists with the implementation of departmental policies, protocols, and systems (i.e., Salesforce) to enhance workflow efficiency and effectiveness.
  • Undertakes additional responsibilities as required to accomplish departmental goals.

Experience, Competencies, And Personal Characteristics :

  • Minimum 2 years of experience in any combination of managed care contract negotiations, resolving payment (claims) issues, or provider enrollment for / in a hospital or health insurance company. Major teaching / surgical hospital experience or health plan experience is highly desirable.
  • Highly desirable experience in Revenue Cycle Management / Analysis.
  • Strong project management skills with a preference for analytical experience.
  • Technologically savvy, with an excellent understanding of processes and databases; proficient with Excel, Word, and PowerPoint. Epic Hospital Billing experience is required.
  • Ability to influence and motivate others, coupled with the capacity to work collaboratively within a multi-stakeholder environment.
  • Excellent oral and written communication skills. Demonstrates a high degree of decorum and professionalism when dealing with stakeholders.
  • Proven ability to take initiative, problem-solve, and prioritize issues. Approaches issue resolution thoughtfully.
  • Education :

  • Bachelor's degree required.
  • Non-Discrimination Policy : Hospital for Special Surgery is committed to providing high quality care and skilled, compassionate, reliable service to our community in a safe and healing environment. Consistent with this commitment, Hospital for Special Surgery provides care, admits, and treats patients and provides all services without regard to age, race, color, creed, ethnicity, religion, national origin, culture, language, physical or mental disability, socioeconomic status, veteran or military status, marital status, sex, sexual orientation, gender identity or expression, or any other basis prohibited by federal, state, or local law or by accreditation standards.

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