Partner & Payer Relations Manager - Denials

What is Aspirion?

Aspirion Health Resources is an industry-leading provider of complex claims management services. We specialize in Motor Vehicle Accidents, Worker’s Compensation, Veterans Administration and Tricare, Complex Denials, Out-of-State Medicaid, and Eligibility and Enrollment Services. Our employees work in an environment that is both challenging and rewarding. We ask a lot out of our team members and in return we offer flexibility, autonomy, and endless opportunities for advancement. As we are committed to growth within the complex claims industry, we offer the same growth to our employees.

What do we need?

We are seeking Partner & Payer Relations Manager who will serve as a key member of the management team responsible for maintaining and enhancing effective and collaborative relationships with clients and payers. Must have effective communication skills to develop and strengthen the relationship between company and the client(s) including the ability to handle difficult conversations and situations while maintaining the highest standard of professionalism. Key responsibilities include collaborating effectively with Operations, Clinical Team, and all departments within Aspirion leading aspects related to strategic planning for new client implementations, leading aspects related to strategic planning for payer escalations, developing and maintaining relationships with appropriate personnel of Aspirion clients’ and clients’ payers, engaging in day-to-day communications to answer questions, prepare payer accountability reports, problem solve and provide feedback, identify upsell and cross-sell opportunities, and assist with development of performance and other custom reports upon request.

What will you provider?

• Attend/Lead meetings between Aspirion and hospital representatives.
• Main point of contact for communications with client(s) and Provider Representatives engaging in day-to-day interactions, answering questions, and providing feedback.
• Main point of contact for communications with payer representatives.
• Interaction with clients and payers - via email, phone, onsite (as needed).
• Monitor and anticipate client needs and concerns and work to address items proactively.
• Works collaboratively with Operations and all other Aspirion departments.
• Create and analyze hospital specific reports.
• Oversee and manage the payer escalation process.
• Document internal and client processes as requested.
• Provide training to Operations on internal processes, client expectations/statement of work, and payer guidelines and procedures.
• Provide communications with clients and Provider Representatives Interaction with clients - via email, phone, onsite (as needed)
• Maintain a professional and HIPAA compliant work area
• Comply with HIPAA protocols and procedures
• Obtain/create supplementary documents to assist in understanding client systems, etc.
• Develop, document, and maintain quality standards that support Advicare objectives and client expectations.
• Evaluate global opportunities presented by a client or department to determine and locate any weaknesses or faults in the procedures/process.
• Provide professional work product
• Assist with account follow up including review in hospital system, as needed
• Participate in team and department meetings
• Assist with projects as assigned
• Assist in maintaining current information on the Intranet
• Utilize resources to enhance performance

Requirements

• Must have a minimum of 6 months of experience with Aspirion as a Denial Resolution Specialist (DRS 3 or Team Lead level), Management or comparative level position or minimum of 6 months experience working in a similar role with a company that performs clinical denials and appeal services.
• Must have excellent analytical skills
• Must have knowledge and proficiency of Office 365 (Word, Outlook, Excel, TEAMS)
• Maintain a high level of professionalism and quality standards
• Must be able to interact with teams, clients and payer at every level of an organization
• Able to work independently
• Understand the importance and benefits of data quality
• Detail-oriented, with good problem solving and research skills
• Able to work in teams and manage time and projects.
• Must have strong written and verbal and interpersonal communication skills.
• Experience in working with payers and/or payer escalations preferred.
• Minimum of 2 years’ experience in Client Management or related field preferred.

Benefits