Payor Specialist - Toledo Hospital - Utilization Management
External
Promedica · RemotePrepare for this interview
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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
Benefits
Additional Information
Location: Remote - Ohio Department: Utilization Management Weekly Hours: 20 Status: Part time Shift: Variable (United States of America) Pay Grade: $15.00 - $30.75 This 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.
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