Payer Profile Specialist

Job Summary

Maintaining the accuracy of the Universal Payer Database, the full-time Payer Profile Specialist will manage payer web portal access, support management projects, and serve as a central contact for cross-functional teams to resolve database and access requests in a remote environment.

Key responsibilities

• Lead the research, setup, and testing of new payer data, including reimbursement terms and claim requirements
• Partner with internal users to troubleshoot and resolve payer data issues efficiently
• Communicate with insurance payers to verify, clarify, and update contract information

Required qualifications

• High School Diploma or equivalent required; a 2-year degree in Business or Healthcare Administration is preferred
• 1-2 years of medical office experience required
• Direct experience with Durable Medical Equipment (DME) and medical billing is highly preferred
• Professional certifications in Microsoft Office or Adobe Acrobat are preferred
• Solid understanding of medical terminology, including modifiers and Coordination of Benefits (COB)