Claims Payment Policy Lead

Job Title: Claims Payment Policy Lead
Job Overview:
Contemporary Staffing Solutions is seeking a Claims Payment Policy Lead to join our client to support the development, governance, and execution of medical and claim payment policies that drive cost efficiency and regulatory alignment. This role plays a key part in translating reimbursement standards and utilization data into actionable policy guidance that supports affordability and operational consistency. The position partners closely with clinical and business teams to evaluate trends, recommend improvements, and present policy direction to internal committees. This is a remote, contract to hire opportunity for candidates residing in Pennsylvania, New Jersey, or Delaware.
Compensation:
Up to $58.50 per hour
Work Schedule:
Monday through Friday, normal business hours
Key Responsibilities of the Claims Payment Policy Lead:
• Lead collaboration with clinical, coding, and business stakeholders to identify, evaluate, and implement policy driven medical cost savings initiatives
• Oversee the development and ongoing maintenance of medical and claim payment policies aligned with nationally recognized reimbursement standards, company benefits, and regulatory requirements
• Monitor reimbursement trends, utilization patterns, and regulatory updates to ensure policies remain compliant, relevant, and cost effective
• Prepare, document, and present policy bulletins, business requirements, and supporting analyses to workgroups and governance committees
• Serve as a subject matter expert and mentor, providing guidance on coding, reimbursement, and clinical policy interpretation across the organization
Qualifications and Skills for the Claims Payment Policy Lead:
• A bachelor’s degree in a related field or equivalent professional experience within healthcare reimbursement or policy functions
• Active coding certification such as CCS, CPC, RHIA, or RHIT, with clinical licensure such as RN considered a strong asset
• At least five years of experience across revenue cycle operations, including practical application of CPT, HCPCS, and ICD 10 coding standards
• Solid understanding of healthcare reimbursement models, payer operations, regulatory guidance, and Medicare rules
• Strong analytical, communication, and organizational skills with the ability to work independently, manage priorities, and lead cross functional collaboration
Why Join Us?
This role offers hands on involvement in meaningful policy and reimbursement initiatives that directly impact cost management and member affordability. You will work closely with diverse clinical and operational teams, gaining visibility across multiple functions. The contract to hire structure provides an opportunity to contribute immediately while building long term value within the organization.
About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp to hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology. Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.