Payer Compliance Specialist

🔥 22 hours ago

🇺🇸 United States – Remote

💵 $24 - $27 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🚔 Compliance

👻 Ghost score 7%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Expressable

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

💰 $15M Series A on 2022-02

Healthcare • Healthcare Insurance • Wellness

Expressable is an online speech therapy service that offers live, 1-on-1 sessions with experienced speech therapists from the convenience of home. Catering to individuals of all ages, Expressable focuses on a range of communication needs, including speech delay/disorder, language disorder, early language development, autism spectrum disorder, and social issues. Clients are matched with therapists who provide custom treatment plans and ongoing support. With an emphasis on practice at home, Expressable delivers research-based, flexible, and effective speech therapy designed to aid swift progress in communication skills.

📋 Description

• Maintain payer setup and readiness, including fee schedules, EFT/ERA configuration, portal access, and payer profile updates • Interpret payer contracts and manuals to extract operational requirements and support clean claim submission • Monitor payer updates and policy changes, assess their impact, and assist with implementation and compliance tracking • Attend new payer orientation meetings and ongoing payer training sessions • Support audit and compliance efforts by assisting with external payer responses • Conduct internal reviews and ensure required training is completed • Maintain up-to-date reference materials • Serve as a resource to internal teams on payer rules and workflows • Collaborate cross-functionally on projects to improve payer compliance, documentation, and training systems

🎯 Requirements

• Associate's or Bachelor's degree in healthcare administration, business, or a related field (or equivalent work experience) • 3+ years of experience in medical billing, revenue cycle operations, payer compliance, or healthcare auditing • Experience working within a healthcare setting is required • Familiarity with payer contracts, reimbursement policies, and healthcare documentation standards • Medical Billing/Coding Certification not required, but a plus • Proficiency with practice management systems, payer portals, and claims processing tools • Experience managing EFT/ERA setup, fee schedules, and provider enrollment data • Strong spreadsheet and document management skills, such as Google Workspace or Microsoft Office • Strong analytical and critical thinking skills to interpret payer policies and identify operational impacts • Effective verbal and written communication skills, including the ability to deliver training and simplify complex topics • Ability to collaborate cross-functionally in a fully remote environment • Adaptability to evolving payer requirements and healthcare regulations • Must be eligible and legally authorized to work in the United States • Visa sponsorship is not available

🏖️ Benefits

• Exceptional paid time off policies that encourage and support life balance • 401k matching • Health insurance options • Company paid life insurance • Company paid short-term disability coverage • Company paid long-term disability coverage • Fully remote work environment • Professional collaboration and personal connection