Payor Relations Analyst managing healthcare payors and ensuring compliance with reimbursement policies. Collaborating across teams to resolve issues and improve processes within the revenue cycle.
Responsibilities
Managing assigned contracted payors as the primary point of contact and subject matter expert, supporting issue resolution and operational alignment.
Ensuring compliance with payor contracts, policies, and reimbursement rules across systems and order-to-cash processes.
Resolving complex accounts receivable issues, including denials, underpayments, and payment delays, to support cash flow performance.
Monitoring payor behavior and policy changes and translating impacts into operational guidance for internal teams.
Partnering cross-functionally with Billing, Collections, Order-to-Cash, and Customer Service teams to drive process improvements and educate stakeholders on payor policy updates.
Requirements
Bachelor’s degree or higher (completed and verified prior to start) from an accredited institution AND two (2) years of experience in healthcare revenue cycle, payor relations, billing, and/or accounts receivable
High School Diploma/GED (completed and verified prior to start) from an accredited institution AND six (6) years of experience in healthcare revenue cycle, payor relations, billing, and/or accounts receivable
Strong understanding of order-to-cash processes.
Ability to analyze and apply payor policies and reimbursement rules operationally.
Strong communication, problem-solving, and relationship management skills.
Ability to manage multiple priorities, escalations, and cross-functional coordination in a fast-paced environment.
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