Contract Compliance Specialist

Job Summary

A company is looking for a Contract Compliance Specialist to manage underpayment reimbursements and analyze payment variances.

Key Responsibilities

• Collect underpayment reimbursements from payers and analyze underpaid claims
• Identify and research root causes of payment variances and develop corrective action plans
• Collaborate with stakeholders to minimize preventable underpayments and monitor trends

Required Qualifications

• Associate's Degree or 3-5 years of experience in hospital billing, collections, or payer contracting
• At least 3 years of claims processing/adjudication experience
• Knowledge of third-party payer and Medicare/Medicaid guidelines
• Understanding of medical terminology and experience with managed care contracts
• Ability to interpret contract terms and knowledge of UB-04 requirements