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

Headquarters located at 2900 Lake Vista Drive, Suite 200, Lewisville, TX 75067.

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 operates in two main segments: Prevention & Recovery, which includes orthopedic solutions like bracing products and therapy systems for rehabilitation and sports medicine, and Reconstructive, which focuses on implant products for various joints and minimally invasive surgical tools. Enovis's products, including well-known brands like DonJoy and Aircast, are designed to address specific medical needs such as pain management and bone growth stimulation. What sets Enovis apart from competitors is its commitment to continuous improvement through the 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

31%

1 year growth

31%

2 year growth

5%
Simplify Jobs

Simplify's Take

What believers are saying

  • Growing demand for minimally invasive surgical tools aligns with Enovis's reconstructive offerings.
  • Personalized medicine trends boost demand for Enovis's customized orthopedic solutions.
  • Aging population increases need for mobility restoration, benefiting Enovis's product market.

What critics are saying

  • Intensifying competition in orthopedic implants may impact Enovis's market share.
  • Rising raw material costs could pressure Enovis's profit margins.
  • Regulatory scrutiny on device safety may increase compliance costs for Enovis.

What makes ENOVIS unique

  • Enovis offers a diverse portfolio of orthopedic and reconstructive solutions.
  • The company focuses on clinically differentiated products enhancing patient outcomes and mobility.
  • Enovis's acquisition of LimaCorporate expands its global footprint in orthopedic implants.

Help us improve and share your feedback! Did you find this helpful?

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

Paid Vacation

Paid Sick Leave

Paid Holidays

Legal Services