Email Opening Title Payer Initiatives Liaison   Description Join us at PRISM for an exciting new career opportunity! Caring Team Environment where YOU matter If youre looking for a career that Satisfies your interest in the medical field with values centered around patient care Gives you a stable, Monday through Friday schedule Provides unmatched training so you are confident in your ability to help others Offers opportunities to help patients and make a difference in other lives everyday then PRISM is the right match for you! Founded in 2006 and headquartered in Elkin, North Carolina, PRISM is a nationwide provider of specialty home medical supplies with a core competency in advanced wound care products. Most recently, Henry Schein, Inc. the worlds largest provider of health care solutions to office-based dental and medical practitioners, announced the acquisition of a majority ownership position in Prism Medical Products, LLC (PRISM). PRISM serves a broad and loyal referral network of nationally affiliated and independently operated wound care clinics, as well as specialist practices and clinics in primary care, ostomy, podiatry, rehabilitation and physical therapy, general and plastic surgery, dermatology, and vascular medicine. PRISM enjoys strong referral retention rates as well as high marks for customer satisfaction. We continue to be a fast-growing home medical supply company that serves our community. Consistently delivering our special recipe of quality and reliable service for all patients, medical facilities, and vendors has made us a unique presence nationwide. We are a valued and trusted health care partner. In our Payer Initiatives Liaison position within our Payer Relations department you will: Understand and execute all facets of the Payer Relations Department involving credentialing, contracting, EDI, Zoho and administrative responsibilities Acquire and maintain a comprehensive understanding of procedures and protocols of internal departments relating to payer contractual obligations, i.e. Client Operations, Billing, Govt. Affairs and Compliance, etc. Ensure accuracy and integrity of payer fee schedules within Trizetto's Advanced Reimbursement Manager system Develop reports to identify and analyze root causes of claim underpayments against contracted rates for the purpose of submitting dispute documentation and tracking recovery efforts with payers Act as a resource, to understand the payer and reimbursement relationships that affect our revenue cycle business performance by monitoring payer trends as it relates to fee schedules under/overpayments to determine the net impact of fee schedule pricing and edit adjustments to make recommendations for contract and fee negotiations Communicate and maintain effective working relationships internally (team members, management) and externally (payers, provider associations, etc.) to accomplish departmental goals and objectives and keeping management informed on related healthcare industry issues/topics. Triage payer issues from provider enrollment, revenue cycle, case management, and other internal departments to formulate and implement projects to expedite resolutions Collaborate with key industry stakeholders at state/regional associations, providers and advocacy groups on all regulatory and legislative changes, navigation of payer relationships and concerns to impact positive results for the industry. Participate actively in team development and assists department in process improvements as it relates to department goals with the objective to streamline operations for more transparency and increased reporting, optimizing communication between teams interdepartmentally Adhere to company policies and procedures regarding employment, safety and compliance. Resolve any area of non-compliance immediately What we offer you: A competitive salary A comprehensive list of health benefits options to choose from Employer match to 401k contributions Robust training programs on professional, technical and leadership skills Paid Holidays Paid Time Off Employee Referral Program Education Reimbursement Community outreach opportunities and more! Why members of #teamPRISM enjoy working here: Prism has a close-knit culture where everyone knows your name and youre not just a number. Its a great family environment and each part of the company works together for the greater good of the patients. Prism is the best company I have ever worked for. I love it here because there are so many growth and development options for me. I learn something new every day and I love the excellent values the company stands behind and upholds to patients and clients every day. BEST PLACE TO WORK! Find your career home! Apply today!   Position Requirements Education/Experience/Knowledge Requirements: Bachelor’s degree in business or other healthcare related field preferred 3 years of experience in medical business organization and operations Ability to work independently, communicate proactively, manage multiple projects and prioritize daily tasks while managing critical deadlines Ability to develop and utilize cross-functional relationships to facilitate the accomplishment of work goals and objectives Advanced presentation skills and excellent overall oral and written communication skills Work requires continual attention to detail in composing, typing and proofing materials, establishing priorities and meeting deadlines Must be able to work in a fast-paced environment with demonstrated ability to juggle multiple competing tasks and demands Must be able to professionally interact and communicate with individuals at all levels of the organization Occasional travel as necessary   Full-Time/Part-Time Full-Time   Shift Days   Position Payer Initiatives Liaison   Exempt/Non-Exempt Non-Exempt   About the Organization PRISM Home Medical Supply Specialists provides seamless delivery of wound care, urological and ostomy supplies. PRISM is one of the fastest growing Home Medical Supply Specialists in the industry and has a reputation of excellence for dedicated service to patients, health care professionals and industry partners. PRISM welcomes talented, motivated, and progressive-thinking professionals to contribute to the company's reputation of excellence! As one of the fastest growing companies in the industry, PRISM offers employees the opportunity to establish a growing and successful career. PRISM's comprehensive training program and autonomous work environment gives individuals the ability to develop personally and professionally. As PRISM continues to grow, we are constantly looking for dynamic, top talent to add to our great team!   EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.   This position is currently not accepting applications. To search for an open position, please go to http://PrismMedicalProductsLLC.appone.com WE ALSO RECOMMEND Other Jobs Within Same Category Client Relations - Healthcare Customer Service (Phones) in Rock Hill, SC Posted on: 4/26/2024 [Apply Now] Compliance Associate - Mon-Fri Day Shift - 3 weeks Paid time Off and more! in Elkin, NC Posted on: 4/15/2024 [Apply Now] Client Relations - Healthcare Customer Service (Phones) in Rock Hill, SC Posted on: 3/11/2024 [Apply Now] Other Jobs Within 60 Miles Compliance Associate - Mon-Fri Day Shift - 3 weeks Paid time Off and more! in Elkin, NC Posted on: 4/15/2024 [Apply Now] Client Operations - Data Entry/Phone Customer Service in Elkin, NC Posted on: 3/11/2024 [Apply Now] Associate Account Manager - Entry Level Medical Sales in Open, NC Posted on: 1/5/2024 [Apply Now] Patient Care Advocate in Elkin, NC Posted on: 5/6/2024 [Apply Now] Care Management Associate Coordinator in Elkin, NC Posted on: 5/7/2024 [Apply Now]

Click here for technical assistance.