SantaAnaRecruiter Since 2001
the smart solution for Santa Ana jobs

IT Manager Payor Requirements - REMOTE/Revenue Cycle Mgmt

Company: CyberCoders
Location: Santa Ana
Posted on: February 20, 2021

Job Description:

We are an established growing organization looking for an IT Manager Payor Requirements to join our team, this is a REMOTE position. This is an IT position in our Revenue Management Systems & Informatics area. In this role you will become the SME and liaison between the technology team and the Revenue Management functional area.

You must have experience with Payor and Provider healthcare insurance, EDI and Medicaid and Medicare knowledge across different states.

The IT Manager Payor Requirements that will be system setup expert in insurance setup, mappings, clean claim requirements and act as liaison between our team and RCM departments. This individual will be on top of payor requirements and make sure communication is aligned across all lanes.

What You Will Be Doing

  • Knowledge of insurance guidelines including Medicare, Medicaid, HMO/PPO and other payor requirements and systems
  • Track and maintain carrier to payor mappings by region. Create a list of key billing requirements such as 2310A suppressions; state Medicaid requirements; HMO plans. Maintain electronic copies of payor manuals highlighting any changes to claim submission and audit new insurance translations in the billing system.
  • Act as a liaison between System Setup and RCM team when payor specific issues arise. As well as identify possible problem payors via denial trends that might result in submission changes
  • Review insurance masters provided from sites during integration to ensure carrier to payor alignment as well as any specific requirements are captured during integration/discovery phase
  • Work with all business owners to validate, approve payor specific requirements as well as educate about any exceptional payor requirements
  • Communicate payor requirement changes to all areas impacted and make sure it is documented via SNOW
  • Assist in development of contract strategies
  • Knowledge of best practices in RCM
  • Continuous improvement mindset and involvement in industry payor requirement changes
  • Audit to insure proper billing system setup payor to carrier mappings and educate team on setup
    What You Need for this Position
    • 5+ years of experience in similar role
    • 3-5 years of analytical experience, problem solving, root cause analysis skills
    • Intermediate Excel, SQL, and other database programs
    • 5+ years of experience with billing system set up preferred
    • Excellent verbal and written communication skills
    • Process Improvement and/or lean experience preferred
    • Experience working with health care data and performing comprehensive drill-down analyses from both a clinical and/or business perspective within the managed care environment
    • Excellent analytical and problem solving skills, across people, process and technology
      What's In It for You

      We the opportunity to be REMOTE and shine as this team grows!!

      So, if you are an IT Manager Payor Requirements with experience, please apply today!

      Email Your Resume In Word To

      Looking forward to receiving your resume through our website and going over the position with you. Clicking apply is the best way to apply, but you may also:

      • Please do NOT change the email subject line in any way. You must keep the JobID: linkedin : RK3- -- in the email subject line for your application to be considered.***
        Rhona Kannon - Principal Director - CyberCoders

        Applicants must be authorized to work in the U.S.

        CyberCoders, Inc is proud to be an Equal Opportunity Employer

        All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, or any other characteristic protected by law.

        Your Right to Work - In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

Keywords: CyberCoders, Santa Ana , IT Manager Payor Requirements - REMOTE/Revenue Cycle Mgmt, Executive , Santa Ana, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Shift Manager
Description: DescriptionWorking at Pizza Hut is about making hungry people happy. It's about being independent and having fun, making new friends and earning extra cash. If you're ready to take the next step in your (more...)
Company: Pizza Hut
Location: Paramount
Posted on: 03/4/2021

Assistant Management
Description: Job DescriptionCompany: Cafe Rio Inc. Position: Assistant Manager Department: Restaurant Management Req : 5039807 Location: 27510 W Lugonia Ave, suites A B Assistant Manager Job Code 01102 Start your (more...)
Company: Cafe Rio
Location: Redlands
Posted on: 03/4/2021

Food Service Assistant Manager
Description: Company: br Cafe Rio Inc. br Position: br Assistant Manager br Department: br Restaurant Management br Req : br 5039807 br Location: br 27510 W Lugonia Ave, suites A B br Assistant (more...)
Company: Cafe Rio Mexican Grill
Location: Redlands
Posted on: 03/4/2021


Assistant General Manager
Description: The Assistant General Manager is responsible for driving successful sales and creating a Wow Guest experience. It is a great opportunity to be a key player in store success. Working closely with the (more...)
Company: Jiffy Lube
Location: La Mesa
Posted on: 03/4/2021

Salon Manager - Morningside Marketplace
Description: Salon ManagerGot shears and a winning attitude Have a yearning to earn and a desire to hire and support other stylists Then let's talk Maybe you're a stylist who wants more responsibility,
Company: Great Clips
Location: Yorba Linda
Posted on: 03/4/2021

Associate Manager
Description: Company: br Cafe Rio Inc. br Position: br Assistant Manager br Department: br Restaurant Management br Req : br 5039807 br Location: br 27510 W Lugonia Ave, suites A B br Assistant (more...)
Company: Cafe Rio Mexican Grill
Location: Redlands
Posted on: 03/4/2021

Senior Project Manager
Description: The Boeing Company is looking for a Senior Project Manager to join our team in El Segundo, CA.- This role is for the Boeing Test Evaluation BT E Project Manager for multiple programs both commercial (more...)
Company: BOEING
Location: Hacienda Heights
Posted on: 03/4/2021

Guest Services Manager
Description: Your new career is just a few clicks away As the global leader in third-party hotel management, our growing portfolio represents 1,400 hotels in 49 states and 20 countries, from top international lodging (more...)
Company: Aimbridge Hospitality
Location: San Clemente
Posted on: 03/4/2021

Systems Engineering and Integration Product Security Manager
Description: The Boeing Defense, Space and Security BDS ,-Space and Launch-Division is seeking a Systems Engineering and Integration Product Security Manager Level L to support the team in El Segundo, CA.- The (more...)
Company: BOEING
Location: Redondo Beach
Posted on: 03/4/2021

Sr Manager, Ad Tech Partnerships
Description: Job Summary:The DTCI Ad Platforms Technology Partnerships Team is a critical function that ensures the DTCI ad platform business can develop the systems, tools, and products necessary to extend and accelerate (more...)
Company: Direct-to-Consumer and International
Location: Lake Elsinore
Posted on: 03/4/2021

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Santa Ana RSS job feeds