Associate Payor Operations Specialist

About the Role

The Associate Payor Operations Specialist is an entry-level professional position supporting the day-to-day operations of the BILHPN Payor Operations department. This role is designed to build foundational knowledge of payor operations, value-based care, healthcare operations, provider practice workflows, revenue cycle processes, stakeholder engagement, and issue resolution.

Key Responsibilities

• Assist with tracking payor deliverables, requirements, deadlines, alerts, notifications, and other payor-related action items.
• Maintain accurate and organized inventories and tracking tools for payor deliverables, requests, communications, issues, and resolutions.
• Coordinate with payor representatives and internal stakeholders to obtain information, confirm requirements, and support timely follow-up.
• Support payor-specific meetings by coordinating schedules, preparing materials, documenting notes and action items, and completing follow-up.
• Assist with the intake, documentation, and routing of payor communications, requests, and operational issues to the appropriate BILHPN team or stakeholder.
• Assist with compiling payor requirements, contract-related information, reports, reference materials, and other documentation for internal stakeholders.
• Support communication and dissemination of payor alerts, notifications, program updates, training information, and operational requirements under the direction of Payor Operations leadership.
• Work with practices and provider groups to support questions, requests, payor-related operational needs, and follow-up, escalating matters requiring additional expertise or authority.
• Coordinate with Revenue Cycle teams and other operational stakeholders to help research and track payor-related claims, billing, reimbursement, enrollment, or workflow issues, as applicable.
• Assist with gathering information from practices, providers, Revenue Cycle, operations, clinical teams, and other stakeholders to support resolution of payor-related issues.
• Assist with monitoring deliverable status and identifying upcoming deadlines, missing information, barriers, or potential risks for escalation to Payor Operations leadership.
• Assist with maintaining and refining standard workflows, reference materials, spreadsheets, Smartsheet trackers, and other tools used to manage payor operations.
• Prepare routine reports, spreadsheets, presentations, correspondence, meeting summaries, and status updates under the direction of Payor Operations leadership.
• Develop and maintain effective working relationships with payor representatives, practices, provider groups, Revenue Cycle teams, BILHPN operational teams, and other stakeholders to facilitate collaboration and timely resolution.
• Participate in training, mentoring, and professional development activities designed to build proficiency in payor operations and progressively assume greater responsibility.

Requirements & Tech Stack

• Proficiency with Microsoft Word, Excel, PowerPoint, Outlook, Teams, and related business applications.
• Familiarity with Smartsheet or similar tracking/workflow tools preferred.
• Strong organizational skills and attention to detail.
• Excellent written and verbal communication skills.
• Professional interpersonal skills and a demonstrated service orientation.
• Ability to establish positive working relationships with payor representatives, practices, provider groups, Revenue Cycle teams, internal departments, and other stakeholders.
• Ability to manage multiple tasks, track follow-up, meet deadlines, and seek guidance when priorities conflict.
• Ability to learn and apply healthcare operations, value-based care, payor requirements, and organizational workflows.
• Strong documentation, meeting coordination, follow-through, and customer service skills.
• Demonstrated willingness to learn, receive coaching, and progressively assume greater responsibility.
• Collaborative and team player.

Qualifications

Education:

• Bachelor's degree in healthcare management, administration, public health, business administration, health services, communications, or a related field preferred. Equivalent relevant education and/or experience may be considered.

Experience:

• 0–2 years of experience in healthcare operations, payor operations, provider relations, practice operations, revenue cycle, customer service, business administration, or a related field preferred.
• Healthcare or provider-facing experience is a plus but is not required for a strong entry-level candidate.

Skills, Knowledge & Abilities:

• Strong organizational skills and attention to detail.
• Excellent written and verbal communication skills.
• Professional interpersonal skills and a demonstrated service orientation.
• Ability to establish positive working relationships with payor representatives, practices, provider groups, Revenue Cycle teams, internal departments, and other stakeholders.
• Ability to manage multiple tasks, track follow-up, meet deadlines, and seek guidance when priorities conflict.
• Ability to learn and apply healthcare operations, value-based care, payor requirements, and organizational workflows.
• Strong documentation, meeting coordination, follow-through, and customer service skills.
• Strong analytical skills and proficiency in data analysis tools and software.

Physical Requirements & Environment

• Requires a high degree of mental and visual concentration.
• Nature of work requires lifting or moving light weight (up to 20 pounds).
• Flow of work and character of duties require average manual coordination.
• Duties require average range of motion.
• Performance of duties allows for variation in positioning and tasks.
• Assignments require constant repetitive motion.
• Working conditions include minimal exposure to elements such as odor, noise, dust, chemicals, temperature extremes or airborne pathogens.
• Performance of duties generally does not involve exposure to hazardous materials.
• No patient care/contact, and does not facilitate the patient care process or directly impact health outcomes.

Pay Range

$25.00 USD - $38.00 USD per hour. Actual compensation is determined based on several factors, including seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

Organizational Requirements

• Maintain strict adherence to all BILH and BILHPN Policies.
• Maintain courteous and effective interactions with colleagues and providers and stakeholders.
• Demonstrate an understanding of the job description, performance expectations, and competency assessment.
• Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to customer service standards.
• Participate in departmental and/or interdepartmental quality improvement activities.
• Participate in and successfully completes Mandatory Education.
• Perform all other duties as needed or directed to meet the needs of the department.
• Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.