Payor Services Manager

About the role

The Payor Services Manager provides enterprise-level leadership for provider claims operations and plays a critical role in the day-to-day management of the Claims team. This role drives operational excellence through process optimization, timely and accurate claims resolution, provider engagement, and continuous improvement initiatives. The position partners with internal stakeholders and external providers to resolve complex claims issues while enhancing operational efficiency, quality, scalability, and customer satisfaction.

Key Responsibilities

• Research, investigate, and resolve complex provider claim issues by analyzing claim history, payer requirements, contracts, and supporting documentation
• Communicate claim issues and resolution expectations to providers in a timely, professional, and customer-focused manner
• Partner with division and site leadership to resolve patient eligibility, referral, and off-site claims processing issues
• Provide leadership, oversight, and direction to claims operations staff while adjusting priorities and resources to meet business needs
• Support staff decision-making, process improvement efforts, and operational initiatives that improve claims accuracy and efficiency

Qualifications

• Bachelor's degree or equivalent experience
• 4+ years of claims management experience preferred
• Certified Professional Coder (CPC)

Benefits

• Medical, dental, and vision insurance
• Paid time off
• 401k
• DailyPay (earn wages as you work)
• Tuition assistance and dependent scholarships
• Employee Assistance Program (EAP) including free counseling and health coaching
• Company paid life insurance
• Tax free Health Spending Accounts (HSA)
• Wellness program featuring fitness memberships and product discounts
• Preferred banking partnership and discounted rates for home and auto loans