Payer Projects Associate

Position Description:

As part of the Revenue Cycle team, the Payer Projects Associate will act as the subject matter expert for the accounts receivable and take full ownership of resolution and management. This position would be an internal champion of Eleanor Best Practice revenue cycle workflows, ensuring that we are accurately capturing, billing, and receiving reimbursement for all services performed. The Payer Projects Associate will report to the Payer Projects Manager.
The ideal candidate is self-motivated, thorough, and tenacious while also communicating effectively and building positive relationships. The flexibility to excel in a startup environment marked by rapid change and short deadlines is essential. Optimism, patience, and enthusiasm are desirable.

Responsibilities:

• Researches and analyzes accounts receivable data and coordinates recovery responsibilities.
• Identifies, analyzes, and researches frequent root causes of denials and front-end holds and develops corrective action plans for resolution.
• Curates and develops relationships with payer representatives to ensure that issues are escalated and resolved in a timely manner.
• Lead and coordinate payer related projects to maximize reimbursement 
• Develop reporting tools that effectively measure and monitor processes throughout the accounts receivable in order to support process improvement.
• Prioritizes activities to work appeals in a timely manner to alleviate untimely filings
• Uses reports that categorize denials to assign tasks or personally work to overturn denials
• Identifies and pursues opportunities for improvements in accounts receivable performance
• Processes work lists to facilitate prompt intervention of insurance denials
• Researches, responds, and documents insurer and patient correspondence/inquiry notes regarding coverage, benefits, and reimbursement on patient accounts
• Researches rejections included in EOBs for resolution and files appropriately
• Makes management aware of any issues or changes in the billing system, insurance carriers, and/or networks

Qualifications: 

• 5+ years experience in dynamic healthcare (clinic, physician, or hospital setting) or payor environment 
• Knowledge of health insurance and reimbursement/billing required. 
• Behavioral health and/or substance use disorder treatment experience preferred
• Athena experience preferred
• Proficiency in Microsoft Office (esp. Excel and Word), Google Business Suite and knowledge of AthenaHealth platform preferred  

Competencies:

• Strong understanding of Revenue Cycle functions, flow, and operations 
• Ability to work independently and take initiative. 
• Ability to manage multiple tasks simultaneously and adjust to issues as needed in a dynamic work environment. 
• Excellent communication skills (verbal and written). 
• Strong organizational skills and superior attention to detail.
• Ability to navigate and comprehend complex payer contracts

Salary & Benefits

The anticipated salary range for this role is $50,000-60,000 annually. The actual compensation offered depends on a variety of factors, which may include, as applicable, the applicant’s qualifications for the position; years of relevant experience; specific and unique skills; level of education attained; certifications or other professional licenses held; other legitimate, non-discriminatory business factors specific to the position; and the geographic location in which the applicant lives and/or from which they will perform the job.

Eleanor Health offers a generous benefits package to full-time employees, which includes:

• • Generous PTO policy - unplug, relax, and recharge!
  • 9 observed company holidays + 3 floating holidays- We encourage you to use the additional 3 floating holidays to accommodate personal beliefs/practices
  • Wellness Days - In lieu of “Sick Time” which typically applies only when you are ill, we encourage you to proactively manage your overall wellbeing, both physical and mental, as well as the wellbeing of those who play important roles in your life.
  • Fully covered medical and dental insurance plan, with affordable vision coverage - We are a health first company, and we strive to make our plans affordable and accessible
  • 401(k) plan with 3% match - We are excited to be able to support the long-term financial well-being of our team in a way that reinforces Eleanor’s commitment to equity.
  • Short-term disability - We understand that things happen, we want you to feel comfortable to take time to get better.
  • Long Term Disability - Picks up where Short Term Disability leaves off (employee paid).
  • Life Insurance - Both Eleanor and employee-paid options are available.
  • Family Medical Leave - Eleanor Health’s Paid Family & Medical Leave (“PFML”) is designed to provide flexibility and financial peace of mind for approved family and medical reasons such as the birth, adoption, or fostering of a child, and for serious health conditions that you or a family member/significant other might be facing.
  • Wellness Perks & Benefits- Mental Health is important to us and we want our employees to have the accessibility you deserve to talk things through, zen with a mindfulness app, or seek assistance from health advocates
  • Mindfulness App Reimbursement

About Eleanor Health

Eleanor Health is the first outpatient addiction and mental health provider delivering convenient and comprehensive care through a value-based payment structure. Committed to health and wellbeing without judgment, Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.

To date, Eleanor Health operates multiple clinics and a fully virtual model statewide across Louisiana, Massachusetts, New Jersey, North Carolina, Ohio, Texas, Illinois and Washington, delivering care through population and value-based partnerships with Medicare, Medicaid, and employers.

If you are passionate about providing high quality, evidence based care for individuals with substance use disorder through an innovative practice and about building a great business that makes a difference, Eleanor Health is an ideal opportunity for you. We seek highly skilled, motivated and compassionate individuals who take responsibility and adapt quickly to change to join our deeply committed and collaborative team.

Job Type: Part-time; remote