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Uw

PAYER RELATIONS SPECIALIST - UWMEDICINE

Seattle, WA · Remote

$90K/yr

Support payer relations operations through research, analysis, and coordination of managed care contracting activities. * Assist with drafting, reviewing, and maintaining contract documents and ...

AnewHealth

OR · On-site

Job Details The Director, Strategic Payer Relations is a leader responsible for managing and advancing strategic relationships with assigned payer organizations. This role serves as the primary ...

AnewHealth

Director, Strategic Payer Relations

Job Details The Director, Strategic Payer Relations is a leader responsible for managing and advancing strategic relationships with assigned payer organizations. This role serves as the primary ...

PRISM

Payer Relations Manager

Elkin, NC · On-site

Title Payer Relations Manager Description The Payer Relations Manager provides all operational oversight and leadership to payer contracting, credentialing, reimbursement support, and communications ...

Glaukos

Payer Relations Director

San Clemente, CA · Remote

The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and maintain favorable coverage, coding, and reimbursement across commercial plans, Medicare (MACs), and ...

Glaukos

Payer Relations Director

San Clemente, CA · On-site

The Payer Relations Director (PRD) leads payer strategy within an assigned region to secure and maintain favorable coverage, coding, and reimbursement across commercial plans, Medicare (MACs), and ...

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How much do payer relations jobs pay per year?

As of Jun 6, 2026, the average yearly pay for payer relations in the United States is $67,404.00, according to ZipRecruiter salary data. Most workers in this role earn between $46,000.00 and $83,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Payer Relations position, and why are they important?

To thrive as a Payer Relations professional, you need a solid understanding of healthcare reimbursement, contract negotiation, and managed care principles, often supported by a degree in healthcare administration or a related field. Experience using contract management software, CRM systems, and knowledge of healthcare regulations such as HIPAA and Medicare/Medicaid requirements is highly beneficial. Strong interpersonal skills, strategic problem-solving, and effective communication make individuals stand out in collaborating with payers and internal teams. These qualities are essential for building productive partnerships, resolving disputes, and ensuring favorable reimbursement outcomes for healthcare organizations.

What are some common challenges faced by Payer Relations professionals?

Payer Relations professionals often encounter challenges such as navigating complex contract negotiations, resolving reimbursement disputes, and staying current with changing healthcare regulations. They must balance the needs of their organization with the requirements and policies of insurance companies, which can sometimes lead to lengthy discussions or intricate problem-solving. Additionally, frequent collaboration with billing, compliance, and clinical teams is necessary to ensure accurate information is shared and issues are resolved efficiently. These challenges make the role dynamic and rewarding for those who enjoy strategic communication and process improvement.

What is a Payer Relations job?

A Payer Relations job involves managing relationships between healthcare providers and insurance companies (payers) to ensure smooth contract negotiations, reimbursement processes, and compliance with regulatory requirements. Professionals in this role work to optimize payer contracts, resolve disputes, and advocate for favorable terms that support both financial and patient care goals. They also monitor industry trends, policy changes, and reimbursement structures to maintain strong partnerships and operational efficiency. Effective communication, negotiation skills, and a deep understanding of healthcare reimbursement are key to success in this field.

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What are the most commonly searched types of Payer Relations jobs? The most popular types of Payer Relations jobs are:
What states have the most Payer Relations jobs? States with the most job openings for Payer Relations jobs include:
What job categories do people searching Payer Relations jobs look for? The top searched job categories for Payer Relations jobs are:
Payer Relations jobs near you
Infographic showing various Payer Relations job openings in the United States as of May 2026, with employment types broken down into 87% Full Time, and 13% Part Time. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $67,404 per year, or $32.4 per hour.
Payer Relations Specialist

Payer Relations Specialist

Springfield Clinic

Springfield, IL • On-site

$19.13 - $27.73/hr

Full-time

This job post has expired today. Applications are no longer accepted.

Springfield Clinic rating

6.6

Company rating: 6.6 out of 10

Based on 57 frontline employees who took The Breakroom Quiz

559th of 867 rated healthcare providers

Job description

Job Description
The Payer Relations Specialist assists with the administrative oversight of payer contracts on behalf of Springfield Clinic. Works closely with Payer Relations Manager to maintain the details of participating network contracts. Provides internal support so that contractual obligations can easily be met while enhancing revenue and patient access and provides general assistance and support to the Director of Managed Care and Payer Relations Manager.
Job Relationships
Reports to the Payer Relations Manager
Principal Responsibilities
  • Collaborates directly with the Director of Managed Care and Payer Relations Manager to support all payer relations business needs.
  • Possess in-depth knowledge and understanding of payer's guidelines, contractual terms, and the processing of Springfield Clinic claims to provide direction and guidance to all internal departments.
  • Responds to payer contract questions as well as benefit and billing questions
  • Coordinates with revenue cycle, quality management, practice operations and credentialing teams to ensure that all payer contractual obligations are met.
  • Rectifies day to day issues for provider service representatives and others within practice operations
  • Receive, research, and perform service recovery as needed
  • Maintains relationships with provider relations representatives with all contracted managed care plans.
  • Identifies issues to discuss in recurring payer meetings.
  • Partner with patient accounting and compliance colleagues to resolve individual cases of improper reimbursement and identify trends.
  • Provide verbal and written communication to all applicable Springfield Clinic practice operations, ancillary, and billing teams related to updates of payer information such as payer provider manuals, provider bulletins and other notices relating to eligibility, covered services, pre-authorization requirements, coding and claim requirements, appeal processes, etc.
  • Analyze and coordinate execution of single case agreements and requested contracts including communications with other teams.
  • Facilitate meetings, display willingness to make decisions within scope of responsibility, and include the appropriate people in the decision-making process.
  • Utilize critical thinking and problem-solving skills when addressing payer, office, and provider concerns
  • Respond promptly to client needs and solicit feedback to improve service, meet commitments and provide follow-up within a timely manner.
  • Develop training aids and train staff on the use of online portals and other tools utilized to obtain prior authorizations in compliance with all payer plans to maximize efficiency
  • Build strong relationships and instill confidence and trust at all levels of the organization including providers.
  • Attends workshops, seminars, and other training programs for educational growth.
  • Comply with the Springfield Clinic incident reporting policy and procedures.
  • Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
  • Provide excellent customer service and adhere to Springfield Clinic's Code of Conduct and Ethics Standards.
  • Perform other job duties as assigned.

Education/Experience
  • Associates Degree in business, healthcare administration, or equivalent experience is required. Bachelors degree is preferred.

Knowledge, Skills and Abilities
  • Conceptual knowledge of principles and practices of healthcare related payer relations/contracts.
  • Strong communication skills are required
  • Ability to manage multiple tasks and work in a fast-paced environment is required.
  • Must be detail oriented and able to deliver a high level of accuracy.
  • Must be proficient in all MS Office applications, including Excel, Access, PowerPoint and Word.
  • Ability to define problems, collect data, establish facts, and draw valid conclusions.
  • Ability to effectively present information and respond to questions from staff and management across the Clinic.
  • Must consistently exercise discretion and sound judgement

Working Environment
  • This job operates in a professional office environment.
  • Routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
  • Occasional travel possible.

PHI/Privacy Level
HIPAA1

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