Principal Associate analyzing Cyber controls and developing automated health metrics for Capital One. Collaborating with teams to transform telemetry data into real - time insights and prevent security risks.
About the role
- 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.
- Experience supporting Commercial, Medicare, Medicaid, and/or Workers’ Compensation payors.
- Familiarity with national and regional health plans.
- Experience participating in cross-functional projects and/or process improvement initiatives.
Benefits
- Medical
- Dental & Vision
- Health Savings Accounts
- Health Care & Dependent Care Flexible Spending Accounts
- Disability Benefits
- Life Insurance
- Voluntary Benefits
- Paid Absences
- Retirement Benefits
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