Healthcare Payment Accuracy Specialist - Remote

Overview

The Healthcare Payment Accuracy Specialist will research and interpret healthcare policies, develop claims editing logics, and collaborate with teams to ensure payment accuracy and transparency across various healthcare sectors.

In Short

• Research and interpret healthcare coding and regulatory requirements.
• Identify common error areas for automated software logics.
• Develop claims editing logics for payment accuracy.
• Collaborate with healthcare policy and technology experts.
• Apply revenue cycle and coding expertise.
• Build unit tests to verify functionality.
• Maintain knowledge of claims edit references.
• Independently meet productivity and quality goals.
• Work remotely and be a self-starter.
• Provide subject matter expertise on claims coding errors.

Requirements

• 8+ years of experience in Healthcare.
• Familiarity with medical coding terminology.
• Experience with prepayment or post-payment processes.
• Intermediate proficiency in Excel.
• Understanding of claims workflow.
• Experience analyzing Medicare/Medicaid data.
• Ability to collaborate across departments.
• Proficient computer skills.
• Nationally recognized coding credentials are a plus.
• Project Management experience is a plus.

Benefits

• Remote work flexibility with home office stipend.
• Equity and 401(k) matching.
• Unlimited PTO and comprehensive health plans.
• Mental and physical wellness support.
• Generous contributions to health premiums.