Healthcare Payment Integrity Specialist

A company is looking for a Healthcare Payer Payment Integrity Specialist. Key Responsibilities: Evaluate variances on paid claims Interpret and calculate payer contract reimbursement methodology Initiate timely appeals and reconsideration with payers Required Qualifications: Bachelor's degree in analytics, healthcare administration, or related field, or equivalent work experience Experience in commercial insurance collections, including claims submission and follow-up Understanding of explanation of benefits Familiarity with revenue cycle structure and processes, including knowledge of CPT and HCPCS codes

Apr 7, 2025 - 17:32

A company is looking for a Healthcare Payer Payment Integrity Specialist. Key Responsibilities: Evaluate variances on paid claims Interpret and calculate payer contract reimbursement methodology Initiate timely appeals and reconsideration with payers Required Qualifications: Bachelor's degree in analytics, healthcare administration, or related field, or equivalent work experience Experience in commercial insurance collections, including claims submission and follow-up Understanding of explanation of benefits Familiarity with revenue cycle structure and processes, including knowledge of CPT and HCPCS codes