Top 203 payor specialist Jobs in remote

Nurse Practitioner
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- Full-time
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Knowtion Health —Remote
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9d
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Infinx —Remote
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Credentialing/Licensing Payor Specialist
Wheel —Remote
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Verse Medical —Remote
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61st Street Service Corp —Remote
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Baylor Scott & White Health —Remote
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Orsini Healthcare —Remote
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AR Specialist
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Certified Medical Assistant
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Medical Billing Specialist
PRN Physical Therapy —Remote
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payor specialist jobs near remote

Nurse Practitioner

Lumina Care -
Remote

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Job Details

Full-time
$60 - $75 an hour

Benefits

Paid holidays
Health insurance
Dental insurance
401(k)
Paid time off
Work from home
Vision insurance

Qualifications

Active listening
Asthma management
Remote patient monitoring
Certified Nurse Practitioner
Primary care
Working with individuals with chronic illnesses
Nurse Practitioner (NP)
APRN Compact
Clinical information systems
Telehealth experience
Patient care
Telehealth platforms
Advanced practice provider
EMR systems
Disease state management
Patient interaction
Typing
Technical Proficiency
Nursing

Full Job Description

Lumina Care is hiring!

Join a team of dedicated providers offering exceptional telemedicine services.

Company overview: Lumina Care is focused on unifying, coordinating, and managing care for geriatric patients in nursing facilities and at home. We offer a range of services to improve health outcomes and quality of life for patients, including after-hours telehealth, transitional care, chronic care, remote patient monitoring, behavioral health, and telehealth psychiatry.

Purpose: We are seeking a full-time Nurse Practitioner or Physician Assistant to join our Community Care delivery team as a fully remote clinician, providing outreach and medical care via telemedicine to patients residing in home or other residential settings.

Job title: Community Care Telehealth Clinician

Hours: Monday – Friday day shift hours

The ideal candidate will be licensed in the following states: NJ, PA, NM, NC, TN, AL, MS, MD, DE, NH, ME, WV, VA, VT.

Role & Core Responsibilities:

Conduct virtual patient visits for Transitional Care Management and Chronic Care Management (post-discharge follow-ups).
Collaborate with Medical Assistants to complete patient visits.
Perform comprehensive clinical assessments and medical decision-making.
Review hospital discharge summaries, diagnostics, and care transitions.
Manage and reconcile medications, including prescribing and adjustments as appropriate.
Identify and address acute issues requiring escalation or in-person care.
Develop, review, and update individualized plan of care.

Care Coordination & Team Collaboration

Collaborate with the Community Care Coordination department on complex clinical needs
Collaborate with the Chronic Care Management (CCM) team of nurses
Delegate appropriate tasks to the Virtual Care Coordinator (CMA)
Communicate clearly with primary care providers, specialists, and community partners
Ensure timely follow-up on home health orders, DME orders, referrals, care support actions and patient/caregiver concerns

Documentation & Compliance

Document visits and care plans accurately in the EHR
Ensure services meet payor requirements for TCM and CCM billing
Adhere to HIPAA, telehealth, and organizational compliance standards
Support quality initiatives and performance metrics related to community care

Patient Engagement & Education

Educate patients and caregivers on diagnoses, medications, and care plans
Promote adherence to treatment plans and preventive care measures
Support patient self-management, acute and chronic disease education

The listed responsibilities are not an exhaustive list and may contain other duties as assigned. Consistent with the Americans with Disabilities Act (ADA), it is the policy of Lumina Care to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship.

Credentials:

Active and unrestricted state licensure in a minimum of five states and willingness to obtain additional if requested.
Collaborative practice agreements will be supplied by Lumina Care as required. When a Nurse Practitioner meets requirements and becomes eligible for autonomous practice in an autonomous state, they will be required to complete the autonomous process and the collaborative practice agreement will be ended.
Active and unrestricted Advanced Practice Nurse, National Board certification (AANP, ANCC or AACN) OR active and unrestricted Physician’s Assistant NCCPA board certification.
Must have an active national provider number (NPI).
Must have active Medicare & Medicaid provider numbers, or willingness to obtain them upon hire.
Must be eligible to participate in the Medicare & Medicaid programs as a provider.

Qualifications:

A minimum of two years' experience as a Nurse Practitioner or Physician Assistant is required, 3-5 years preferred.
Previous Community Care experience is preferred
Long term care experience is preferred
Telehealth experience is preferred
Extensive knowledge of chronic diseases, especially COPD/asthma, Diabetes, CHF and CAD are required.
Experience managing patients with polypharmacy, completing gradual dose reductions (GDRs) and addressing deprescribing opportunities is preferred.
Excellent clinical skills with an ability to assess, diagnose, develop a treatment plan and communicate in a virtual environment
Technology proficiency required.
Excellent people skills: communicating with patients, families, and members of the healthcare team.
Self-directed with the ability to practice autonomously, but functions as a member of the team.

Compensation:

This role will be full-time Monday through Friday and will be composed of Community Care delivery work.

$60-$75 per hour (within the range, geography, individual pay is determined by job-related skills, experience, licensure, and relevant education or training).

We offer a comprehensive and competitive benefits package to support our employees, including:

Medical, Dental, and Vision Insurance
Paid Time Off (PTO)
Paid Holidays and Floating Holidays
Flexible Work Arrangements

Working conditions:

A quiet work from home space and a functional computer are required for this remote role. Typing is required, as well as using virtual technology to visualize patients during visits. Periods of prolonged sitting or standing can be expected. Travel requirements could occur based on specific state licensure.

Summary:

Lumina Care is an Equal Opportunity Employer. We consider all qualified applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other characteristic protected by law. We are excited for you to join our team.

Job Type: Full-time

Pay: $60.00 - $75.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Application Question(s):

Are you licensed in any the following states: NJ, MD, DE, NH, NM, PA, ME, WV, VA, VT, TN, NC, RI, IL, WA, AL?

Experience:

Telehealth: 1 year (Required)
EMR systems: 1 year (Required)

License/Certification:

Certified Nurse Practitioner (Required)

Work Location: Remote

Quick Apply

Refine Your Search

payor specialist jobs in remote

Nurse Practitioner

Billing Specialist (Big Law Firm Exp Preferred)

Medical Benefits Billing Verification Specialist

Denials Specialist

Dental Insurance Specialist

Revenue Cycle Specialist

Credentialing and Licensing Specialist

Credentialing/Licensing Payor Specialist

Revenue Cycle Specialist

Professional Billing Specialist

Revenue Cycle Specialist

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Billing Specialist

RCM Enrollments Specialist

Accounts Receivable Specialist I #Full Time #Remote

Insurance Verification Specialist 2 - Prior Authorization (Hybrid - Dallas)

Quality Program Specialist

AR Specialist

Certified Medical Assistant

Medical Billing Specialist

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