Payer Operations Manager
Children's Healthcare of AtlantaAtlanta, GA, USjob_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionRegistered Nurse licensure with 2 years of experience in clinical criteria that establishes medical necessity in all clinical settings or bachelor's degree in business or health-related discipline Bachelor's Degree in Business or health-related discipline; or equivalent experience in lieu of degree No professional certifications required Well-developed organizational, communication and interpersonal skills Must be able to work with confidential information Advanced PC skills Excellent analytical and problem-solving skills Ability to research and analyze concepts and details Ability to document and succinctly present research findings Ability to explain, present or discuss difficult information and gain group consensus Ability to work within deadlines and resource constraints Ability to interact effectively with managers, staff and outside stakeholders Ability to function effectively as a part of a team Ability to understand and interpret clinical documentation Facilitates and manages assigned third-party payer operations meetings, monthly claims calls, or ad-hoc meetings in coordination with Revenue Cycle and CPG to ensure operational issues are being addressed in an efficient manner. With the Director, Managed Care Operations, develops and implements strategies to administer Children's contracts with third-party payers, whilst preserving Children's contractual rights. Builds and maintains strong collaborative relationships with both third party payers and internal stakeholders. Communicates identified payer operational issues to both internal and external parties, acting as mediator and troubleshooter in disputes with third party payers. Develops, tracks, and maintains project plans and strategies for assigned third party payers. Identifies possible solutions to overcome roadblocks / barriers to internal stakeholders and leadership. Serves as a resource for internal stakeholders to troubleshoot complex authorization, claim or denial issues. In coordination with Managed Care Contracting, Revenue Cycle, Utilization Review, CPG, Performance Analytics, and Service Lines, ensures all issues are being addressed, updated, and communicated. Reviews third party payer correspondence or communication for potential issues that would impact both operational and clinical processes. In coordination with Performance Analytics and Finance Project Management, provides detail for Children's mitigation strategy. Communicates regular notifications to multiple departments informing them of changes in third party policies and requirements. Assists Director, Managed Care Operations, Director, Managed Care Contracting and Vice President. Managed Care to complete strategic and business plans as required by Children's. Performs other activities related to Children's managed care activities, as requested. Supports and participates in the continuous assessment and improvement of the quality of care and services provided.
Third Party Payer Operations Manager
Children's is one of the nation's leading children's hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We're committed to putting you first, and that commitment is at the heart of our company culture : People first. Children always. Find your next career opportunity and make a difference doing what you love at Children's.
Tracks, manages, and communicates the status of assigned third party payer issues and operational initiatives. Facilitates designated meetings with payers toward actionable outcomes. Collaborates with the Director, Managed Care Operations to identify strategic solutions and coordinate proactive follow-up and reactive issue management with appropriate representatives from both external and internal stakeholders.
Experience :
- 3 years of experience working at a payer or provider in a relevant role involving provider / payer relationships
- Experience with revenue cycle operations
Preferred Qualifications :
Education :
Certification Summary :
Knowledge, Skills, and Abilities :
Job Responsibilities :
Primary Location Address : 1575 Northeast Expy NE
Job Family : Managed Care
serp_jobs.job_alerts.create_a_job
Operation Manager • Atlanta, GA, US
Job_description.internal_linking.related_jobs
A company is looking for a Bilingual Payment Solutions Growth Manager.Key Responsibilities Proactively identify, qualify, and sign prospective partners to the Payments Platform, providing trainin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
DC Operations Manager - 1st Shift.Job Category : Distribution Center.Requisition Number : DCOPE010500.Location : Newnan Distribution Center, 60 Herring Road, Newnan, GA 30265, USA.Organizational skill...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Head of Field Payer Team to lead payer engagement and access initiatives for gene therapies.Key Responsibilities Lead and coach a team of Account Executives for market ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for an Operations Manager to oversee daily workflows and optimize performance across various departments.
Key Responsibilities Maintain and monitor daily operational workflows...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Manager of Accounting Operations in the Philippines.Key Responsibilities Assist in reviewing daily funding requirements and employee reimbursements Oversee the account...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Job Location : THQ-Business Services - Atlanta, GA.Position Type : Full Time Regular.Job Summary : Plans, develops, coordinates, and manages accounting operations for the Southern Territorial Headquar...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Emory Healthcare Revenue Cycle Manager.At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
At Abby Care, we are tackling one of the most important and unsolved challenges of our time : family caregiving.Over 50 million Americans are family caregivers for loved ones without pay, tools, or ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Stellantis Financial Services (SFS) is the new captive finance company for one of the world's leading automakers and a mobility provider with iconic brands including Abarth, Alfa Romeo, Chrysle...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Payments Ops Analyst I (Remote).Key Responsibilities Perform daily functions related to ACH, Wire, and RTP processing in a remote environment Ensure efficient delivery...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day A company is looking for a Revenue Cycle Manager - Cash Applications.Key Responsibilities Lead and manage the daily operations of the payment posting team, including domestic and offshore staff ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Posting Expires : 10 / 03 / 25 Salary Range : $68,156.General Description and Classification Standards : The Accountant II performs professional accounting and auditing work independently and at the full ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Director, North American Payroll Operations.Morgan Stanley is a leading global financial services firm providing a wide range of investment banking, securities, investment, and wealth management se...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days A company is looking for a Revenue Cycle Operations Manager to lead and scale a high-performing RCM team.Key Responsibilities : Manage and lead a team of RCM Associates, providing performance feed...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 
Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days 
Oversee the full-cycle accounts payable process, ensuring timely and accurate processing of invoices, credit memos, and payments.
Lead, mentor, and manage AP team members across multiple locations, ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days Emory Healthcare Job Opportunity.At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30 A company is looking for a Director, Payer Revenue Management.Key Responsibilities Oversee Patient Billing, Collections, Customer Services, Refunds / Credit Balance, and Payment Posting Provide le...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day 
As the Tailoring Operations Manager you are responsible for creating and sustaining tailoring operational policies, procedures, and processes.
Your focus will be working with both the in-store tailo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
- serp_jobs.job_card.promoted
Bilingual Payment Solutions Manager
VirtualVocationsDecatur, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
DC OPERATIONS MANAGER - 1st Shift
Roses Discount StoresNewnan, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Head of Field Payer Team
VirtualVocationsAlpharetta, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Operations Manager
VirtualVocationsLawrenceville, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
CPA Manager of Accounting Operations
VirtualVocationsLawrenceville, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Accounting Operations Manager
Salvation Army Southern TerritoryAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Sr Manager, Revenue Cycle Ops
Emory HealthcareAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Program Operations Manager
Abby CareAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Payment Processing Team Manager
Stellantis Financial Services USAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Payments Operations Analyst
VirtualVocationsAlpharetta, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Revenue Cycle Manager
VirtualVocationsAlpharetta, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Program Operations Manager (Accountant II - Invoice Administrator)
City of AtlantaAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Director, North America Payroll Operations
Morgan StanleyAlpharetta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Revenue Cycle Operations Manager
VirtualVocationsAtlanta, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Manager, Account Services (PINS)
Zelis Healthcare, LLCAtlanta, GA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Manager, Client Services
Zelis Healthcare, LLCAtlanta, GA, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Accounts Payable Manager
Aston CarterAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Sr Manager, Operations
Emory HealthcareAtlanta, GA, USserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Director of Payer Revenue Management
VirtualVocationsNorcross, Georgia, United Statesserp_jobs.job_card.full_time
- serp_jobs.job_card.promoted
Tailoring Operations Manager
Tailored BrandsAtlanta, GA, USserp_jobs.job_card.full_time