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Managed Care Payor and Systems Specialist

Company: LHC Group Inc Home Office
Location: Lafayette
Posted on: November 15, 2019

Job Description:

Overview
The Payor & Systems Specialist is responsible for the appropriate set up of non-governmental payors in all systems and research of new payors for ongoing business as well as growth.

Additional Details
Payor Research and System Support:
This position is responsible for timely and accurate set up of payors within the billing systems by:
Reviewing requests for new payor set up in a timely manner
Completing research in the current system and externally to ensure that payor dictionaries and chargemasters are accurate
Assists supervisor as needed to update payers in accordance to each state and contracts that are ""normal"" in that state.
Ensures timely and accurate support to the field in the areas of insurance/benefits verification and coverage.
Research and resolve eligibility and claims issues.
Prepares chargemasters and other routine updates for revenue cycle systems, which include, but are not limited to, the billing and collection systems as well as all analytical tools
Monitors payer websites and disseminates pertinent information to the appropriate departments.
Acquisitions Support
This position supports the onboarding of new home health and hospice providers by:
Assists supervisor/coordinator with coordination with the Transition team before the acquisition close date to ensure a smooth transition to each LHC Computer System and timely billing and collections.
Assists Supervisor/Coordinator to conduct initial and ongoing communication with new acquisitions regarding their current contracts. With Managed Care Supervisor and/or Revenue Cycle Manager, facilitates planning for managed care ""transition patients"" and negotiations of LOAs.
Research and coordinate the gathering of payor requirements such as, but not limited to state regulations, processing time, change of ownership process and required documentation, backdate requests, health plan backlogs, required group enrollment documentation, adverse legal history, authorized-delegated information and payer timeframes for submission.

Secondary Functions
Acts as a resource to staff for problem solving. Ensures that problem-solving occurs at the lowest level possible with positive outcomes.
Participates in the development of Department best practices. Assists supervisor/manager to develop and implement procedures to facilitate efficient workflow and paper flow within the Department.
Ensures Department compliance with company, departmental, and regulatory processes and procedures.
Analyzes all processes related to job functions and organizes work in a manner conducive to a high level of productivity on a daily basis.

Qualifications
Formal Education: High school diploma or equivalent; College Education preferred
Experience: 1-3 Years Revenue Cycle Experience, preferably billing and collections
Skill Requirements

  • Must be highly organized, efficient, and able to handle multiple tasks with ease and professionalism.
  • Must possess administrative, analytical, problem-solving, and time management skills.
  • Must have a thorough working knowledge of computers and applicable office software including Microsoft Office Suite (Adobe Professional, Outlook, Word, Excel, Access, Power Point), internet research, and database programs.

    Company Description:

    Our company was founded over 20 years ago on the principle that ---it---s all about helping people,--- and we live by those words today. It---s our mission to provide exceptional care and unparalleled service to patients and families who have placed their trust in us. We grow to fulfill this mission. When you become part of the LHC Group family, you---re choosing a career path that will challenge you to grow both personally and professionally.Every day, all across the country, our LHC Group family is helping people. There are 10,000 of us, standing shoulder to shoulder, helping the patients in our care live, fuller, healthier lives. We do this because helping people is, quite simply, the reason we exist. It---s our purpose.--

Keywords: LHC Group Inc Home Office, Lake Charles , Managed Care Payor and Systems Specialist, Other , Lafayette, Louisiana

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