Tennessee Oncology is seeking an experienced Payer Relations Manager to join our group. This is an excellent opportunity for long term success with an established, stable and successful practice.
Tennessee Oncology provides the highest quality of care and service to our patients and employees as well as advances the science of cancer care through the development of innovative treatments and clinical trial participation. We are motivated to continually invest in the latest technology and attract the most talented team of Health-care professionals.
PURPOSE OF JOB:
The Payer Relations Manager is responsible for acting as the Tennessee Oncology representative with payers for administrative items. The position will also supervise the Credentialing team and support them in their duties. This is accomplished by building/maintaining payer contacts with payers with which Tennessee Oncology is contracted and those with which it does business in a less formal way. The Payer Relations Manager will assist other Patient Accounting team members with underpayments, incorrect payments, non-par issues, contract questions and other matters relevant to payer relations.
Supervise and assist the Credentialing team; meet weekly at a minimum.
Communicate regularly with key payer contacts in order to build/maintain relationships.
Review new payer contracts for language appropriateness using Contract Check List.
Negotiate Single Case Agreements (SCA’s) as necessary.
Work with imaging billing organizations to address payer issues.
Distribute information and tools provided by payers to appropriate Tennessee Oncology people/departments.
Ensure necessary documents (amendments, etc.) are reviewed, approved, signed and delivered to payers as necessary.
Address and ensure correction of payment anomalies identified by Patient Accounting Analysts.
KNOWLEDGE, SKILLS AND ABILITIES:
Ability to communicate with a diverse group of individuals with various degrees of training and education.
Excellent written and verbal communication skills with the ability to effectively communicate and establish collaborative relationships with physicians, clinical and administrative staff, and payers.
High level of customer service ethic with courteous demeanor and the ability to process patient and public inquiries, including complaints, and respond with poise and efficiency.
Knowledge of clinic office procedures, medical practice and medical terminology.
Knowledge of organizational policies, procedures, systems and objectives.
Knowledge of Managed Care Organizations and payer guidelines.
Ability to interpret, adapt and apply guidelines and policies and procedures.
Ability to review, interpret and suggest contract language.
Ability to organize, delegate, and supervise.
Ability to recognize, evaluate and solve problems.
Ability to plan, implement and manage multiple projects simultaneously.
Ability to use proper grammar, spelling, punctuation and sentence structure to answer correspondence and prepare reports.
Strong organizational skills and attention to detail.
High level of discretion to work with confidential information.
Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient scheduling and other medical information systems.
Ability to operate various types of office equipment .
QUALIFICATIONS, REQUIRED EDUCATION AND EXPERIENCE:
Minimum of five years healthcare experience; preferably with Oncology/Hematology knowledge.
Bachelor’s degree or equivalent healthcare related experience required.
Excellent management and leadership skills
Knowledge of 3rd party payer regulations
Basic Microsoft Excel and Word
Must be willing to attend meetings with payers both on and off site.
Salary: Commensurate with experience
Schedule/Hours: Typically 8:00 AM - 4:30 PM Monday - Friday
Location: Baptist MOB – Downtown Nashville
Tennessee Oncology - 2 years ago
Tennessee Oncology, PLLC is committed to leadership and excellence in oncology care. We believe that each patient deserves the highest...