Payor Insurance Relations Specialist

Payor Relations Specialist - Full Time - Rancho Mirage, California

**Registered Nurse preferred. 

Join our world-class team of driven, passionate healthcare professionals who are focused on service excellence and providing top quality care!

Rehabilitation Hospital of Southern California, located in Rancho Mirage, CA, is a premier inpatient rehab facility serving patients throughout the Coachella Valley and Southern California region. We provide intensive rehabilitative care for individuals recovering from strokes, brain and spinal cord injuries, orthopedic surgeries, and other serious conditions.

Our experienced rehabilitation team delivers comprehensive therapies – from advanced physical and occupational therapy to specialized neurological rehabilitation – all in a warm, supportive environment. The hospital features state-of-the-art equipment and individualized care plans to help patients reach their recovery goals.

Accredited by The Joint Commission, the Rehabilitation Hospital of Southern California is committed to exceptional patient outcomes and compassionate care.

We are seeking a Payor Relations Specialist to join our team of passionate patient caregivers!

As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs.  These programs focus to enhance the employees’ work experience, recognize, and celebrate achievements.  We also encourage employees to share their work experience through “My Ernest Journey” and through our Engagement Survey, where our approach is “You Spoke, We Listened”.  These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them.

Our hospital offers comprehensive benefits, designed to support your health and financial well-being.

Benefits:

• PPO and High Deductible Medical Plan options
• Flexible Spending and Health Savings Account options available
• Dental and Vision coverage
• 401K with employer matching
• Life insurance
• Short-and-long term disability

Wellness & Work Life Balance:

• Employee Assistance Program
• Wellness Program with quarterly wellness challenges with participation incentives
• Earned Time Off - start accruing vacation time on start date

Professional Growth:

• Continuing education opportunities 

Required Skills:

• Current state RN license preferred.
• Two years recent experience in Utilization Review preferred
• OR any equivalent combination of education and experience.

Additional Qualifications/Skills:

• Knowledge of clinical operations and procedures.
• Knowledge of the compliance and regulatory standards governing health plans and patient care.
• Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.
• Demonstrates general computer skills including: data entry, word processing, email, and record management.
• Effective organizational and time management skills.
• Effective written and verbal communication skills.
• Ability to maintain proper levels of confidentiality.
• Ability to work closely and professionally with others.
• Ability to maintain quality, safety, and/or infection control standards.

The Payor Relations Specialist is responsible for obtaining and maintaining service authorizations from third-party payors to ensure reimbursement for services provided, before, throughout, and after a patient stay.  They will work directly with insurers, managed care organizations, and clinical staff to ensure the treatment needs of the patients are met, maximizing their overall outcomes and quality of life.