Full-Time

Payor Relations Analyst

Confirmed live in the last 24 hours

ENOVIS

ENOVIS

1,001-5,000 employees

Develops orthopedic and reconstructive medical devices

Healthcare

Mid, Senior

Dallas, TX, USA

Category
Financial Planning and Analysis (FP&A)
Finance & Banking

You match the following ENOVIS's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • 3 – 5 years’ experience in a medical reimbursement environment (e.g., patient billing, claims processing, healthcare/insurance contracting support)
  • Proficiency in insurance/payor reimbursement including an understanding of payors on a national scale
  • Demonstrated knowledge of managed care and other payor’s guidelines and criteria for reimbursement
  • Demonstrate ability to interpret payor policy and criteria
  • Exceptional verbal and written communication skills to internal and external customers required
Responsibilities
  • Maintains relevant reimbursement payor databases including policy, billing, pricing information, contract agreements, and non-contracted payor demographics
  • Monitors, audits, and follows up on all new agreements at 60-120-180 days to ensure the agreement is functioning appropriately with all reports and resources provided
  • Proactively identifies trends that are attributing to aged Accounts Receivable and contractual write-offs resulting from payor (external) and operational (internal) non-compliance with the contract and problem-solves with the appropriate party (i.e., payor and/or internal departments)
  • Responsible for all credentialing and licensure requests from payors to maintain current accreditation and access to plan members under assigned geographic region
  • Applies, maintains, and updates all State Medicaid plan information
  • Monitors State Medicaid website, provider portal, and fee schedules, and completes annual enrollment and/or credentialing/attestations to ensure Enovis has an in-network participating status under assigned geographic region
  • Researches and responds to inquiries from internal departments regarding contracted payors’ participation status, and internal operational processes
  • Works with Payor Development Leadership to interpret third-party payor coverage policies, maintaining documentation requirements necessary to support Medical Necessity of Enovis products and services
Desired Qualifications
  • 3-5 years payor credentialing experience with DME provider

Enovis develops medical technology solutions aimed at improving patient outcomes and restoring mobility. The company offers a range of products divided into two main segments: Prevention & Recovery and Reconstructive. The Prevention & Recovery segment includes orthopedic solutions like rigid braces, soft goods, vascular therapy systems, and hot and cold therapy products, which are designed for rehabilitation and sports medicine. The Reconstructive segment focuses on implant products for various joints and provides tools for minimally invasive surgeries. Enovis differentiates itself from competitors through its commitment to continuous improvement, guided by its Enovis Growth Excellence (EGX) system, which enhances operations and customer satisfaction. The company's goal is to innovate in the medical technology field to create better outcomes for patients and healthcare providers globally.

Company Stage

IPO

Total Funding

N/A

Headquarters

Wilmington, Delaware

Founded

2022

Growth & Insights
Headcount

6 month growth

30%

1 year growth

30%

2 year growth

2%
Simplify Jobs

Simplify's Take

What believers are saying

  • Growing demand for minimally invasive surgical solutions boosts Enovis's market potential.
  • Integration of digital health technologies opens new avenues for product innovation.
  • LimaCorporate acquisition expands Enovis's market share in the European orthopedic sector.

What critics are saying

  • Increased competition from Stryker and Zimmer Biomet in the orthopedic market.
  • Potential supply chain complexities from integrating LimaCorporate operations.
  • Regulatory challenges in obtaining FDA approvals for new products.

What makes ENOVIS unique

  • Enovis offers a diverse portfolio of orthopedic and reconstructive solutions.
  • The company integrates advanced materials like vitamin E-doped polyethylene in implants.
  • Enovis's acquisition of LimaCorporate enhances its transatlantic business capabilities.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

Paid Vacation

Paid Sick Leave

Paid Holidays

Legal Services