You bring your body, mind, heart and spirit to your work as a Payer Relations Manager.
You know how to move fast. You know how to stay organized. You know how to have fun.
Youâ™re great at what you do, but you want to be part of something even greater. Because you believe that while individuals can be strong, the right team is invincible.
System Services is our Corporate Headquarters in Broomfield, Colorado and is located within the Oracle campus. SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the well-being of the people we serve. This role will initially sit at our Technology office in Lakewood, CO and eventually move to the corporate office in Broomfield in 2019.
Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: it encompasses body, mind and social well-being. To that end, weâ™ve launched a Healthy Living program to address your holistic health. Healthy Living includes financial incentives, digital tools, tobacco cessation, classes, counseling and paid time off. We also offer financial wellness tools and retirement planning.
Together weâ™ll align mission and careers, values and workplace. Weâ™ll encourage joy and take pride in our integrity.
Weâ™ll laugh at each otherâ™s jokes (even the bad ones). Weâ™ll hello and high five. Weâ™ll celebrate milestones and acknowledge the value of spirituality in healing.
Weâ™re proud of what we know, which includes how much there is to learn.
As a Payer Relations Manager you need to know how to:
Manage the relationship with payers, governmental and non-governmental, to ensure all areas of the health system are appropriately operationalizing payer policies and procedures in order to ensure the reliability and predictability of revenue attributable to those payers.
Develop methods of improving information throughput and end use information acquisition to ensure revenue cycle operations remains compliant with payer policies, and assist in the development of processes to minimize denials, payment delays, and maximize revenue.
Produce and provide regular educational sessions to end users across the health system that orient those operational areas to new payers, and new payer policies that would impact revenue and revenue cycle operations.
Host and facilitate monthly joint operations committee (JOC) meetings with contracts payers to establish a consistent method of communication and issue identification and resolution.
Oversee the payment variances team and ensure payers are paying the health system as expected to ensure the integrity of revenue expectations. Use intelligence gleaned through the payment variance team to address payer and/or Epic build related issues.
Identifies trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts.
Serves as a liaison to internal teams like HB & PB billing, provider strategies, Finance, and payment variance vendors like nThrive to leverage contract terms and mitigate revenue leakage and denials.
Helps design and implement improvements to established, or proposed, reimbursement process flows in order to maximize potential revenue.
We hire people, not resumes. But we also expect excellence, which is why we require:
High School Diploma or Equivalent, required
Bachelorâ™s Degree, preferred
Three (3) years of experience in revenue cycle insurance follow up or denial management, required
Three (3) years experience in a complex invoice/billing/reconciliation environment, highly preferred
Extensive knowledge of managed care contract interpretation, highly preferred
Your next move.
Now that you know more about being a Payer Relations Manager on our team we hope youâ™ll join us. At SCL Health youâ™ll reaffirm every day how much you love this work, and why you were called to it in the first place.
Located in Broomfield, CO., currently working in a remote capacity with periodic onsite work.
Internal Number: 1022
About SCL Health
SCL Health is a faith-based, nonprofit healthcare organization dedicated to improving the health of the people and communities we serve, especially those who are poor and vulnerable. Founded by the Sisters of Charity of Leavenworth in 1864, our $2.8 billion health network provides comprehensive, coordinated care through eight hospitals, more than 150 physician clinics, and home health, hospice, mental health and safety-net services primarily in Colorado and Montana.