Payroll Integration Specialist, 360
PCS Retirement
Payer Compliance Specialist
Expressable
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $24 - $27 per hour
Job Level
Mid-LevelSenior
About the role
- Support audit and compliance efforts by assisting with external payer responses, conducting internal reviews, and ensuring required training is completed.
- 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.
- Maintain up-to-date reference materials and serve as a resource to internal teams on payer rules and workflows.
- Monitor payer updates and policy changes, assess their impact, and assist with implementation and compliance tracking; attending new payer orientation meetings and ongoing payer training sessions.
- Collaborate cross-functionally on special projects to improve payer compliance, documentation, and training systems.
Requirements
- Associate’s or Bachelor’s degree in healthcare administration, business, or a related field (or equivalent work experience).
- 3+ years of experience in medical billing, revenue cycle operations, payer compliance, or healthcare auditing.
- 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 (e.g., Google Workspace or Microsoft Office).
