Payor Specialist – Utilization Management
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Job Description
Payor Specialist handling payer notification and securing authorizations as patients are admitted at ProMedica. Working remotely, addressing payer requests and documenting determinations in Epic.
Responsibilities:
- Responsible for payer notification and securing authorizations
- Submit clinical information per payer contract to obtain authorization for appropriate level of care and length of stay
- Document all payer determinations in Epic
- Communicate the payer requests to the unit manager nurse after authorization is received
Requirements:
- High School Diploma
- Must have access to high-speed internet in your home
- Previous experience with Epic (preferred)
- Previous experience with insurance guidelines, federal regulations (preferred)
Benefits:
- Dental
- Vision
- Company paid life insurance
- Paid time off
- 401k retirement plan
- Employee assistance program
- Other voluntary coverage options
- Employee discounts
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