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Healthrules Payor Jobs (NOW HIRING)

MJHS

Enrollment Coordinator

Manhattan, NY · On-site

$35K - $43K/yr

... HealthRules Health Rules Payor in accordance to department guildelines. -Completes enrollment acceptance or deferral calls according to specified deadlines and ensures to document accordingly in MP ...

HealthEdge

Senior Software Engineer

$125K - $165K/yr

You will play a pivotal role in integrating our HealthRules software suite with client systems ... payor) domain preferred. • Agile development experience (SCRUM, Kanban) and ability to work ...

HealthEdge

$122K - $161K/yr

You will play a pivotal role in integrating our HealthRules software suite with client systems ... Prior experience in the healthcare or health insurance (payor) domain preferred. Agile development ...

HealthEdge

... Payor, Connector Classic, CPrime, Enrollment, Provider Directory). * Cross-train the Release ... Experience with HealthRules Payer, Connector, Enrollment, or Provider Directory product ...

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Healthrules Payor information

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How much do healthrules payor jobs pay per hour?

As of Jul 2, 2026, the average hourly pay for healthrules payor in the United States is $18.87, according to ZipRecruiter salary data. Most workers in this role earn between $16.35 and $20.19 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a HealthRules Payor specialist, and why are they important?

To thrive as a HealthRules Payor specialist, you need a solid understanding of healthcare insurance operations, business analysis, and experience with payer systems, often supported by relevant degrees or certifications in healthcare IT or business. Proficiency in HealthRules Payor software, claims processing platforms, and data analysis tools like SQL or Excel is typically required. Strong problem-solving, communication, and stakeholder management skills help specialists excel in collaborating across technical and business teams. These skills are critical for ensuring the effective configuration, implementation, and optimization of HealthRules Payor systems, which support accurate claims processing and regulatory compliance.

What are some common challenges Healthrules Payor professionals face when implementing system upgrades or new modules?

Healthrules Payor professionals often encounter challenges related to system integration, data migration, and adapting to changing regulatory requirements during upgrades or the implementation of new modules. Ensuring that existing workflows are not disrupted and that all users are properly trained on new functionalities is critical. Collaboration with IT, compliance, and business operations teams is essential to address issues quickly and maintain seamless claims processing and member management throughout the transition.

What is the difference between Healthrules Payor vs Health Insurance Underwriter?

AspectHealthrules PayorHealth Insurance Underwriter
Required CredentialsTypically requires a degree in health administration, business, or related field; certifications like CPCU or AHIP are commonRequires a degree in finance, economics, or actuarial science; professional certifications like ASA or FSA are often preferred
Work EnvironmentOffice-based, working with healthcare data, policy management, and payer systemsOffice-based, analyzing risk, reviewing policy applications, and calculating premiums
Employer & Industry UsageUsed by health insurance companies, healthcare payers, and managed care organizationsEmployed by insurance companies, reinsurance firms, and actuarial consulting firms

While both roles involve working within the health insurance industry, Healthrules Payor focuses on managing healthcare payer systems and policy administration, whereas Health Insurance Underwriters primarily assess risk and determine policy premiums. Understanding these differences helps clarify career paths and job expectations in the health insurance sector.

What is HealthRules Payor?

HealthRules Payor is a core administrative processing system (CAPS) used by health plans and insurance companies to manage critical business operations such as claims processing, member enrollment, and provider management. It is designed to be flexible, scalable, and configurable to meet the evolving needs of health insurers. HealthRules Payor helps organizations improve efficiency, ensure compliance with regulations, and deliver better service to members and providers. The system can integrate with other healthcare IT solutions and supports value-based care initiatives.
More about Healthrules Payor jobs
What cities are hiring for Healthrules Payor jobs? Cities with the most Healthrules Payor job openings:
What states have the most Healthrules Payor jobs? States with the most job openings for Healthrules Payor jobs include:
What job categories do people searching Healthrules Payor jobs look for? The top searched job categories for Healthrules Payor jobs are:
Healthrules Payor jobs near you
Infographic showing various Healthrules Payor job openings in the United States as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $39,247 per year, or $18.9 per hour.
Enrollment Coordinator - Bilingual Mandarin/Cantonese

Enrollment Coordinator - Bilingual Mandarin/Cantonese

Metropolitan Jewish Health System

Manhattan, NY • On-site

$35K - $43K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Job description

Overview
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
  • Tuition Reimbursement for all full and part-time staff
  • Generous paid time off, including your birthday!
  • Affordable and comprehensive medical, dental and vision coverage for employee and family members
  • Two retirement plans! 403(b) AND Employer Paid Pension
  • Flexible spending
  • And MORE!

MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)
Responsibilities
-Enters enrollee data and clinical information into Market Prominence (MP) and ensures the
completeness and accuracy of the demographic information to successfully manage and report outcomes to leadership and to governing bodies.
-Functions in tandem with teammates to ensure all NTUCs are closed promptly upon receiving formal NTUC note.
-Accurately enters request for service authorizations into HealthRules Health Rules Payor in
accordance to department guildelines.
-Completes enrollment acceptance or deferral calls according to specified deadlines and ensures to document accordingly in MP.
-Provides exceptional customer service during phone calls received and outgoing on the ACD line.
Qualifications
  • High School diploma
  • Bachelor's degree preferred
  • With Bachelor's degree; minimum of one year of experience in Managed Care, provider billing, and/or customer service.
  • Without Bachelor's degree, minimum of three (3) years of experience, as above
  • Knowledge of Microsoft Office

Min
USD $35,041.49/Yr.
Max
USD $43,801.86/Yr.

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