Payment Integrity Specialist

Job Summary

Responsible for reviewing and analyzing underpayment records and managed care contracts, the full-time Payment Integrity Specialist will ensure compliance with contract terms for billing and maximize reimbursement while working remotely.

Key responsibilities

• Review and maintain underpayment records and managed care contracts to ensure accurate payments
• Develop and oversee standard operating procedures for claim adjudication and reimbursement analysis
• Facilitate communication and education regarding payment processing policies and managed care issues with internal departments and payors

Required qualifications

• Associate degree in healthcare or business-related field, or a minimum of three years of prior healthcare revenue cycle experience
• Experience working with Excel spreadsheets is required
• Minimum of two years of prior healthcare experience with an understanding of healthcare reimbursement preferred
• Must meet standard productivity requirements prior to transitioning to a home-based position