Payor Change Coordinator- Remote

About the role

The Payor Change Coordinator plays an important role in helping ensure patients receive uninterrupted service when their insurance or payor information changes. You’re not simply processing insurance changes. You’ll help patients navigate changes in their coverage while making sure the right information, authorization, product, and payor are in place for their care. Working remotely, you’ll have the opportunity to solve problems, work across multiple teams, communicate directly with patients and payors, and make a meaningful impact behind the scenes to keep patient care moving forward. This is a fully remote work-from-home position. Employees are expected to have an appropriate workspace and the ability to perform the essential functions of the position remotely. This is primarily a stationary position that requires frequent sitting or standing, repetitive wrist motions, grasping, speaking, listening, close vision, color vision, and the ability.

Responsibilities

• Fully remote position – work from home
• Patient-focused role supporting patients through insurance changes
• Combination of insurance verification, problem solving, and customer service
• Regular interaction with patients, payors, branches, and referral sources
• Opportunity to identify and resolve billing and documentation issues
• Work that directly supports accurate reimbursement and continued patient service
• Process patient insurance and payor changes accurately and efficiently
• Verify insurance coverage, eligibility requirements, and payor information by phone and online
• Obtain verbal or written authorization for medical treatment from appropriate sources
• Ensure the correct product and payor are used for services, equipment, and therapy
• Verify that the appropriate allowable is recorded in accordance with payor contracts
• Research and resolve account issues, including gaps between current and former payor requirements and billing documentation
• Review accounts to ensure open and future invoices are billed correctly
• Identify and resolve discrepancies in insurance information and account documentation
• Answer inbound calls from patients regarding updates to their insurance and provide clear information about next steps
• Coordinate with patients, branches, and referral sources to obtain required testing based on new payor requirements
• Notify patients and coordinate scheduling for required testing
• Document account activity accurately in ACIS and other required systems
• Help ensure payment is guaranteed prior to delivery and revenue is posted appropriately
• Follow all regulatory requirements, company policies, procedures, and best practices
• Support additional duties and projects as assigned

Requirements

• High school diploma or equivalent
• At least one year of related work experience
• At least one year of medical billing experience
• Familiarity with payor contractual requirements
• Strong attention to detail and ability to identify and resolve discrepancies
• Strong verbal and written communication skills
• Ability to work effectively with patients, payors, branches, and internal teams
• Basic computer skills, including Microsoft Word, Excel, PowerPoint, Access, MS Project, and Visio
• English reading, writing, and speaking skills

Skills

• Detail-oriented and organized
• Strong problem-solving skills
• Clear and professional communication
• Comfortable working with patients and insurance payors
• Able to research information and resolve issues independently
• Strong follow-through and personal accountability
• Ability to manage multiple priorities in a fast-paced environment
• Business acumen and understanding of how payor requirements impact the business
• Professional and credible when communicating with patients and internal teams

Benefits

• Medical, dental, and vision care coverage
• Paid time off plan
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