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Remote Payor Relations Jobs in Ohio (NOW HIRING)

Remote Payor Relations information

What are the most common challenges faced by professionals in remote payor relations roles, and how can they be effectively managed?

Professionals in Remote Payor Relations often encounter challenges such as navigating complex insurance policies, staying updated with frequently changing payor requirements, and fostering effective communication across virtual teams. Managing these challenges involves maintaining organized documentation, leveraging digital tools to track payor updates, and proactively collaborating with internal departments like billing and compliance. Developing strong relationships with payors and participating in ongoing training also help ensure smoother negotiations and issue resolution.

What is the difference between Remote Payor Relations vs Remote Claims Specialist?

AspectRemote Payor RelationsRemote Claims Specialist
CredentialsHealthcare experience, insurance knowledge, communication skillsMedical coding, billing certifications, attention to detail
Work EnvironmentOffice or remote, interacting with payers and providersRemote, processing and reviewing claims
Employer & IndustryHealthcare insurers, providers, third-party administratorsHospitals, clinics, insurance companies
Search & Comparison IntentUnderstanding payer relations, insurance negotiationsClaims processing, billing, reimbursement issues

Remote Payor Relations roles focus on managing relationships with insurance payers, negotiating coverage, and ensuring smooth communication. Remote Claims Specialists handle claims processing, billing, and reimbursement tasks. While both roles operate within the healthcare insurance industry and may require similar healthcare knowledge, their core responsibilities differ—one emphasizes payer relations, the other claims management.

What is a remote payor relations specialist?

Remote Payor Relations professionals manage the relationships between healthcare providers and insurance payors from a remote location. Their primary responsibilities include negotiating contracts, resolving billing issues, ensuring compliance with regulations, and facilitating communication between providers and insurance companies. Working remotely, they leverage digital tools to handle documentation, meetings, and data analysis, helping organizations maximize reimbursements while maintaining positive partnerships with payors.

What are the key skills and qualifications needed to thrive as a remote payor relations specialist?

To thrive as a Remote Payor Relations Specialist, you need a strong understanding of healthcare reimbursement, contract negotiation, and insurance regulations, often supported by a bachelor's degree in healthcare administration or a related field. Familiarity with payer portals, claims management systems, and contract management software is typically required. Excellent communication, problem-solving, and relationship-building skills help you navigate complex issues with payers and internal teams. These capabilities are essential to securing favorable contracts, resolving claim disputes, and ensuring financial stability for healthcare organizations.

What are the most commonly searched types of Payor Relations jobs in Ohio?

The most popular types of Payor Relations jobs in Ohio are:

What are popular job titles related to Remote Payor Relations jobs in Ohio?

For Remote Payor Relations jobs in Ohio, the most frequently searched job titles are:

What cities in Ohio are hiring for Remote Payor Relations jobs?

Cities in Ohio with the most Remote Payor Relations job openings:

Pharmaceutical Sales Specialist - Cleveland, OH

Alcon

Cleveland, OH • On-site, Remote

Full-time

Medical, Life, Retirement

Re-posted 3 days ago


Alcon rating

7.3

Company rating: 7.3 out of 10

Based on 68 frontline employees who took The Breakroom Quiz

322nd of 538 rated manufacturers


Job description

Additional Job Description
At Alcon, we are driven by the meaningful work we do to help people see brilliantly. We innovate boldly, champion progress, and act with speed as the global leader in eye care. Here, you'll be recognized for your commitment and contributions and see your career like never before. Together, we go above and beyond to make an impact in the lives of our patients and customers.
We foster an inclusive culture and are looking for diverse, talented people to join Alcon. As a Dry Eye Pharmaceutical Sales Specialist, you will be responsible for covering a large territory and will focus on a defined target list of physicians/practitioners within the territory. One will also assure the needs of all partners are met within compliance guidelines while developing relationships and maintaining an active presence in the pharmaceutical community or associated organizations throughout the territory area of Cleveland, OH (Remote Field Based).
In this role, a typical day will include:
  • Build disease awareness with key partners, validated understanding of treatment initiation processes, patient identification etc.
  • Collaborate with partners, internally and externally, on prior authorization, payor restrictions, reimbursement stipulations, and patient referrals to support patient access.
  • Manage the sales budget and grow sales across the territory through development of impactful territory plan and engaging communications.
  • Employ business planning and local market knowledge to develop sales and customer networks.
  • Grow relationships and communications with all partners and communities to develop solid understanding of treatment algorithm and business dynamics within accounts.
  • Implement compliant and medically relevant programs to effect significant customer satisfaction and sales.
  • Cover and visit all customers in the area of responsibility according to their importance and potential.
  • Manages accounts for all business-related aspects (sales, negotiation, development, relation with owner and managers, define solutions for customer needs).
  • Develop excellent and fruitful relations with customers and opinion leaders.
  • Participate, develop, and conduct different meetings and events (congresses, round tables, trainings).
  • Establish and present action plans to achieve sales target.
  • Plan and track agreed account metrics and clearly communicate the progress of monthly/quarterly.
  • Keeps constant touch on market evolution.
  • Coordinate trainings, informative programs, and product presentations.
  • Prospect the market for new accounts and identify grow opportunities.

Key Requirements/Minimum Qualifications:
  • Bachelor's Degree or Equivalent years of directly related experience (or high school +10 yrs.; Assoc.+6 yrs.; M.S.+0 yrs.)
  • The ability to fluently read, write, understand, and communicate in English
  • 2 Years of Relevant Experience
  • Territory: Cleveland, OH
  • Relocation Assistance: Not Available
  • Sponsorship Available: Not Available

Preferred requirements:
  • Experience in sales account management.
  • 2 Years of Proven Experience
  • Health Care Industry (preferred eye care pharmaceutical or medical device field)
  • Technical learning and agility.
  • High-energy, self-starter as well as collaborative team player.
  • Result oriented with strong drive to make it happen.
  • Willingness to challenge status quo.
  • Excellent communication and negotiation skills.
  • Self-control, self-confidence, reliability, strong business acumen and organization skills.
  • Driving license -category B

How to Thrive at Alcon:
  • Manage your own workload and schedule while hitting your set targets.
  • Build positive working relationships to achieve positive goals and business objectives.
  • Balance experiencing new environments and working autonomously in a remote sales environment.
  • Alcon provides robust benefits package including health, life, retirement, flexible time off for exempt associates, and much more!

Alcon Careers
See your impact at alcon.com/careers
ATTENTION: Current Alcon Employee/Contingent Worker
If you are currently an active employee/contingent worker at Alcon, please click the appropriate link below to apply on the Internal Career site.
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ALCON IS AN EQUAL OPPORTUNITY EMPLOYER AND PARTICIPATES IN E-VERIFY
Alcon takes pride in maintaining an inclusive environment that values different perspectives and our policies are non-discriminatory in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, marital or veteran status, disability, or any other legally protected status. Alcon is also committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please send an email to alcon.recruitment@alcon.com and let us know the nature of your request and your contact information.

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