State Licensed Payment Policy Specialist

A company is looking for a Senior Specialist, Payment Policy to join their Payment Integrity team. Key Responsibilities Serve as a subject matter expert for reimbursement policies and payment integrity processes Respond to inquiries and disputes regarding payment policies and edits Research industry coding rules and collaborate with partners to address adverse claim outcomes Required Qualifications Bachelor's degree or 4+ years of relevant experience 4+ years in claims processing, coding, auditing, or healthcare operations 3+ years in medical coding with certification from AAPC or AHIMA Experience with reimbursement methodologies and claims processing practices 2+ years of experience deriving insights from datasets and improving workflows

Mar 21, 2025 - 20:15

A company is looking for a Senior Specialist, Payment Policy to join their Payment Integrity team. Key Responsibilities Serve as a subject matter expert for reimbursement policies and payment integrity processes Respond to inquiries and disputes regarding payment policies and edits Research industry coding rules and collaborate with partners to address adverse claim outcomes Required Qualifications Bachelor's degree or 4+ years of relevant experience 4+ years in claims processing, coding, auditing, or healthcare operations 3+ years in medical coding with certification from AAPC or AHIMA Experience with reimbursement methodologies and claims processing practices 2+ years of experience deriving insights from datasets and improving workflows