Payer Compliance Specialist

Job Summary

To support revenue cycle management, the full-time Payer Compliance Specialist I will analyze claim amounts, manage variances, and communicate with internal teams and insurance companies while working remotely.

Key responsibilities

• Analyzes and validates payer variances to ensure compliance with contracts
• Manages corrective actions for variances through appeals and escalations
• Researches and reports on payer systemic issues impacting receivables

Required qualifications

• High school diploma or equivalent required
• Minimum of 2 years of experience in healthcare revenue cycle
• Functional knowledge of Excel and Word
• Basic understanding of managed care programs and healthcare billing requirements
• Familiarity with CPT, ICD-9, and ASA coding preferred