Payor Specialist - Toledo Hospital - Utilization Management
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AI Summary
Location:
Remote - OhioDepartment:
Utilization ManagementWeekly Hours:
20Status:
Part timeShift:
Variable (United States of America)Pay Grade:
$15.00 - $30.75This is a remote position; however, employment is limited to residents of certain U.S. states due to legal, tax, and regulatory requirements. At this time, we cannot offer employment to individuals residing in California, Colorado, Hawaii, Massachusetts, New Jersey, New York, Oregon, Pennsylvania, Washington, or U.S. territories. Eligibility is based an applicant’s primary residence at time of hire.
Job Summary:
As patients are admitted at ProMedica, the Payor Specialist is responsible for payer notification and securing authorizations.
You will submit clinical information per payer contract to obtain authorization for appropriate level of care and length of stay as needed. You will document all payer determinations in Epic.
Once authorization is received, you will communicate the payer requests to the unit manager nurse.
The above summary is intended to describe the general nature and level of work performed by the positions; it should not be considered exhaustive.
REQUIREMENTS
- High School Diploma
- Must have access to high-speed internet in your home
PREFERRED REQUIREMENTS
- Previous experience with Epic
- Previous experience with insurance guidelines, federal regulations
ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus.
Benefits:
We offer a competitive benefits package with coverage effective day one of employment which includes dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts.
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org
Equal Opportunity Employer/Drug-Free Workplace
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