Payer Compliance Specialist

Job Summary

A company is looking for a Payer Compliance Specialist to ensure adherence to payer requirements and internal compliance standards.

Key Responsibilities

• Support audit and compliance efforts by assisting with external payer responses and conducting internal reviews
• Maintain payer setup and readiness, including fee schedules and portal access
• Collaborate cross-functionally on special projects to improve payer compliance and documentation

Required Qualifications

• 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, or payer compliance
• Familiarity with payer contracts and healthcare documentation standards
• Proficiency with practice management systems and claims processing tools
• Experience managing EFT/ERA setup and provider enrollment data