MANAGER- PAYOR RELATIONS
000641-REVENUE CYCLE INTEGRITY
Work Hours: Monday " Friday, 8:00 a.m. " 5:00 p.m.
For a 3rd year in a row, Aspirus has been recognized as one of the top 15 Top Health Systems in the United States by IBM Watson in their annual study identifying the top-performing health systems in the country based on overall organizational performance.
We are seeking a Manager of Payor Relations in Wausau, WI at Aspirus, Inc. The Payor Relations Manager provides leadership in protecting the reimbursement of Aspirus in management of payor relationships, maintaining the integrity of payor and contract information, and ensuring timely enrollment of providers with payors. This position is critical to the advancement of Aspirus' thorough understanding of payors and our relationship with them so that processes can adjust as this portion of healthcare changes. In this position, the Payor Relations Manager oversees teams that focus on ensuring payor contracts are understood, appropriate payments are received from payors, underpayments are appealed, and ensures Aspirus facilities and providers are timely and accurately enrolled with contracted payors. This position is responsible to build constructive relationships with Aspirus payors through regular meetings, review of performance metrics, and the resolution of elevated issues within Aspirus through collaborating with Aspirus Network or working directly with the payor. The Payor Relations Manager also provides education to Aspirus on new payors and plans to ensure proper identification and handling for our Aspirus patients. The Payor Relations Manager facilitates and plays a key role in governance and steering committees over the areas of responsibility.
- Knowledge of healthcare financial management or related field normally acquired through completion of a Bachelor's Degree in Business, Finance, Accounting, or other health related profession.
- Three to five years of experience supporting a managed care or payor relations functions at either health plan or provider organizations.
- Knowledge of contract language provisions and payor relations-oriented issue resolution.
- Experience preparing and working with financial analysis of high complexity.
- Supervisory or management experience necessary to develop administrative skills, including work experience in project management is preferred.
- Previous experience with auditing and internal controls is preferred.
- Working knowledge of current Medicare, Medicaid, and other regulatory or payor guidelines and requirements.
- Possesses a high level of resourcefulness, innovation, and interpersonal and critical thinking skills.
- Possesses project management and implementation skills necessary to develop and implement appropriate changes impacting revenue and reimbursement.
- Detailed knowledge of revenue cycle functions and revenue flow.
- Understanding of Industry specific terminology.
Hours: Full-time, Monday " Friday, 8:00 a.m. " 5:00 p.m. with flexibility, 80 hours per pay period. Benefits package available.
Aspirus Wausau Hospital is the flagship of the Aspirus system that serves patients in 14 counties across northern and central Wisconsin, as well as the Upper Peninsula of Michigan. It is a licensed private/not-for-profit facility with 325 beds and staffed by 350 physicians in 35 specialties. Aspirus Wausau Hospital is a Level II trauma center that provides primary, secondary and tertiary care services as a regional referral center. Specialty referral service emphasis exists in cardiology and cardiothoracic surgery, orthopedics and cancer. The hospital has an average daily inpatient census of 160 with approximately 15,000 admissions per year. Outpatient visits exceed 50,000 and there are also more than 24,000 annual emergency department visits.
Best known for its world-class cardiovascular program, Aspirus Wausau Hospital also provides leading edge cancer, trauma, women's health, and spine and neurological care.
As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.
Click on the following links: Learn more about Wausau click here: Wausau, Wisconsin