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Payment Integrity Specialist

VirtualVocations

Responsible for reviewing and analyzing underpayment records and managed care contracts, the full-time Payment Integrity Specialist will ensure compliance with contract terms and maximize reimbursement while working remotely. Key responsibilities Review and maintain underpayment records and managed care contracts to ensure accurate billing and reimbursement Develop and document standard operating procedures to ensure consistency in claim adjudication and compliance Conduct extensive research and analysis on managed care issues, facilitating communication and education with internal departments and payors Required qualifications Associate degree in healthcare or business-related field, or a minimum of three years of prior healthcare revenue cycle experience Experience working with Excel spreadsheets is required Minimum of two years of prior healthcare experience with an understanding of healthcare reimbursement is preferred Ability to meet standard productivity requirements before transitioning to a home-based position

Vacancy posted 9 days ago
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