Payor Development Specialist

Northside Hospital Inc

Atlanta, GA, US
Fully remote
Centers of excellence contractual arrangements
Managed care payor relations
Coe bundled surgical arrangements
Northside Hospital is seeking a Payor Development Specialist to support its payor development team, focusing on operationalizing Centers of Excellence (COE) contractual arrangements. The role involves relationship management, contract maintenance, and education for physician practices, requiring strong analytical and communication skills

Job Summary

  • The Payor Development Specialist is responsible for operationalizing Centers of Excellence contractual arrangements within the Managed Care department.
  • This role serves as a primary point of contact between billing staff, provider practices, and COE health plans to resolve claim and process issues.
  • The position requires supporting negotiations, providing physician practice education, and ensuring accurate contract identifiers and coding implementation.

Matching Summary

Match Score: 85

Northside Hospital is seeking a Payor Development Specialist to support its payor development team, focusing on operationalizing Centers of Excellence (COE) contractual arrangements. The role involves relationship management, contract maintenance, and education for physician practices, requiring strong analytical and communication skills.

Skills & Requirements

Must-have

  • Centers of Excellence contractual arrangements
  • Managed Care payor relations
  • COE bundled surgical arrangements
  • Contract and fee schedule maintenance
  • Claims adjustment process management

Nice-to-have

  • Strong analytical skills for trended issues
  • Excellent organizational and communication skills
  • Ability to work independently in remote setting

Key Requirements

  • Bachelor's Degree or equivalent experience
  • No less than four years healthcare experience
  • Provider contracting or provider relations experience

Work Rights

Not specified

Tailored Resume

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