Payer Compliance Specialist
New
E
ExpressableSpeech Therapy
100% Remote (anywhere in the US)Full-TimeMiddle
Salary24 - 27 USD per hour
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Job Details
- Experience
- 3+ years of experience
- Required Skills
- Microsoft OfficeGoogle Workspace
Requirements
- Associate's or Bachelor's degree in healthcare administration, business, or a related field, or equivalent experience.
- 3+ years of experience in medical billing, revenue cycle operations, payer compliance, or healthcare auditing.
- Experience working within a healthcare setting.
- Familiarity with payer contracts, reimbursement policies, and healthcare documentation standards.
- Proficiency with practice management systems, payer portals, and claims processing tools.
- Experience managing EFT/ERA setup, fee schedules, and provider enrollment data.
- Strong spreadsheet and document management skills using Google Workspace or Microsoft Office.
- Detail-oriented with strong analytical and critical thinking skills.
- Effective verbal and written communication skills.
- Ability to collaborate cross-functionally in a fully remote environment.
Responsibilities
- Maintain payer setup and readiness including fee schedules, EFT/ERA configuration, portal access, and payer profile updates.
- Interpret payer contracts and manuals to extract operational requirements and support clean claim submission.
- Monitor payer updates and policy changes, assess their impact, and assist with implementation and compliance tracking.
- Support audit and compliance efforts by assisting with external payer responses and conducting internal reviews.
- Maintain up-to-date reference materials and serve as a resource to internal teams on payer rules and workflows.
- Collaborate cross-functionally on special projects to improve payer compliance, documentation, and training systems.
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