Managed Care Payor and Systems Specialist
Company: LHC Group Inc Home Office
Posted on: November 15, 2019
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.
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.
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
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.
Acts as a resource to staff for problem solving. Ensures that
problem-solving occurs at the lowest level possible with positive
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
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
Formal Education: High school diploma or equivalent; College
Experience: 1-3 Years Revenue Cycle Experience, preferably billing
- 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.
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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