Payor Specialist - Weekend

Job Summary

To support the timely provision of clinical information to third-party payors, the full-time Payor Specialist - Weekend will manage utilization review functions, communicate determinations to care teams, and maintain documentation in a remote environment.

Key responsibilities

• Completes all utilization review functions, including notification of admissions and processing denials
• Communicates payor determinations and level of care coverage to patient care teams
• Maintains documentation of review dates, authorizations, and denials per payer guidelines

Required qualifications

• High School Diploma or equivalent
• Two years of experience in a healthcare setting
• One year of payor relations experience
• Knowledge of third-party payers
• Ability to use computers effectively