Payment Variance Specialist – Physician Revenue Cycle

Job not on LinkedIn

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $38k - $64k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Identify, investigate, and recover discrepancies between expected insurance-payer reimbursement and actual payments for physician and professional services • Follow and ensure compliance with client and company policies and procedures • Compare paid claims against managed care contracts, fee schedules, and expected rate matrices to identify underpayments, overpayments, and unapplied contractual adjustments • Initiate payer disputes, follow up on open inventory, and draft appeals with commercial or government insurance companies • Investigate root causes including system configuration or contract-load errors, coding mistakes, and payer pricing errors • Handle insurance and patient refunds or credit-balance reporting in compliance with Medicare guidelines • Track recurring underpayment trends, maintain aging inventory reports, and communicate financial impact to revenue-cycle leadership • Identify, validate, and report project trends and issues • Update spreadsheets and monitor outstanding client items • Provide updates to leadership, clients, and team members • Act as a role model for the team, office, and company • Perform all other job-related duties as assigned

🎯 Requirements

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED • 1-3+ year's experience in office, business, operations, customer service, healthcare payor, provider, revenue cycle, or professional services environment • Strong physician claims payment variance background • Demonstrated proficiency in relevant revenue cycle processes with high production and quality standards • Strong verbal and written communication skills to effectively communicate with staff and client • Demonstrated proficiency interpreting relevant coding systems including, but not limited to, CPT and HCPCS and ICD-10 in a fast-paced environment • Demonstrated leadership qualities fostering team cohesion, accountability, and high performance • Demonstrated proficiency researching billing guidelines • Demonstrated skills providing training and mentoring to team members • Strong understanding of all software/systems used • No travel required • No clearance required

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time & Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement, Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program • Flexible benefits package • Flexible work arrangement (remote)

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