- Chicago, Illinois, United States
- Hybrid
- Full-time
- 5+ years
Lead Payor Specialist supports the Quality Utilization team to efficiently communicate with payors and ensure timely initial stay authorization and continued stay authorizations for acute care inpatients.
Responsibilities
- Leads the work of Payor Specialists within the department.
- Serves as a role model and resource to Payor Specialists and other staff regarding Payor Specialists Best Practices.
- Provides training and orienting to all Payor Specialists, and maintains training and orientation materials and records.
- Reviews cases escalated by the Payor Specialists for appropriateness and accuracy of documentation and process.
- Reviews cases escalated by the Quality Utilization Specialists that may have authorization challenges. Further escalates cases as appropriate.
Requirements
- Bachelor’s degree
- Nice to have: Master’s Degree in healthcare-related field
- Nice to have: 7+ years of relevant experience
- Nice to have: Acquired certifications relevant to position