Payer Compliance Specialist I
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Job Description
Payer Compliance Specialist analyzing allowed claims amounts and resolving payer issues at US Anesthesia Partners. Requirements include revenue cycle experience and healthcare billing knowledge.
Responsibilities:
- Analyzes allowed amounts received on USAP claims to determine appropriateness per contract
- Reviews electronic and manual postings associated with variances
- Appeals for re-processing and/or requests corrections as necessary
- Identifies and resolves payer issues that negatively impact receivables
- Communicates with various internal USAP RCM departments and insurance companies
- Displays a positive demeanor and professionalism in communications
- Demonstrates independent thinking and problem-solving skills
- Meets deadlines and handles potentially stressful situations and multiple tasks
Requirements:
- High school graduate or equivalent required
- Minimum of 2 years experience in healthcare revenue cycle
- Functional knowledge of Excel and Word required
- Basic knowledge of managed care programs and healthcare billing requirements necessary
- Analytical abilities to identify and resolve underpayments relating to specific payers, coding issues, etc. are required
- Good mathematical, verbal, and written communication skills
- Experience gathering and reporting information
- Must display a teamwork attitude and possess good interpersonal skills
- Ability to work independently with limited supervision
- Familiarity with basic medical terminology and concepts preferred
- Knowledge of CPT, ICD-9, and ASA coding preferred
Benefits:
- Eligible for a quarterly bonus
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