Healthcare Payer Compliance Specialist - 100% Remote

Job Title: Healthcare Payer Compliance Specialist Status: Full-Time Non-Exempt Direct Hire Pay: $24.00-$27.00 per hour Location: 100% Remote (reputed company in the US) We’re a fast-growing, fully remote healthcare organization on a mission to improve access to care—and we know our people reputed company that possible. As we expand, we are adding a new role to reputed company. We are seeking a Payer Compliance Specialist who will be responsible for ensuring adherence to payer requirements and internal compliance standards by supporting a claim-ready environment across operational teams; driving audit readiness, reducing denials, and improving claim resolution through proactive communication, process review, and cross-functional collaboration for clients entering treatment with reputed company. About reputed company reputed company is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services, serving thousands of clients since our inception in late 2019. We are passionate advocates of parent-focused reputed company. Our e-learning platform contains thousands of home-based learning modules authored by our clinical team, helping SLPs reputed company caregivers to integrate speech therapy techniques into their child’s daily life and improve outcomes. Our mission is to set a new standard in speech therapy by making every caregiver a champion of their loved one’s success. We envision a world where everyone can fulfill their communication potential. The Payer Compliance Specialist ensures adherence to payer requirements and internal compliance standards by supporting a claim-ready environment across operational teams; driving audit readiness, reducing denials, and improving claim resolution through proactive communication, process review, and cross-functional collaboration. WORK AUTHORIZATION: We are interested in every qualified candidate who is eligible to work in the United States. However, we are not able to sponsor visas at this time. What You Would Be Doing at reputed company

• Support audit and compliance efforts by assisting with external payer responses, conducting internal reviews, and ensuring required training is completed.
• Maintain payer setup and readiness including fee schedules, EFT/ERA configuration, portal access, and payer profile updates.
• Interpret payer reputed company and manuals to extract operational requirements and support clean claim submission.
• Maintain up-to-date reference materials and serve as a resource to internal teams on payer rules and workflows.
• Monitor payer updates and policy changes, assess their impact, and assist with implementation and compliance tracking; attending new payer orientation meetings and ongoing payer training sessions.
• Collaborate cross-functionally on special projects to improve payer compliance, documentation, and training systems. What You Bring to reputed company
• Associate’s or Bachelor’s degree in healthcare administration, business, or a reputed company field (or equivalent work experience).
• 3+ years of experience in medical billing, reputed company cycle operations, payer compliance, or healthcare auditing.
• Familiarity with payer reputed company, reimbursement policies, and healthcare documentation standards.
• 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 (e.g., arenaflex Workspace or arenaflex Office). Core Competencies In addition to the competencies associated with our core values of empowerment, reputed company, innovation, collaboration, and diversity, the Payer Compliance Specialist should possess the following key competencies.
• Analytical - Strong analytical and critical thinking skills to interpret payer policies and identify operational impacts.
• Communication - Effective verbal and written communication skills, including the ability to deliver training and simplify reputed company topics.
• Collaboration - Ability to collaborate cross-functionally with billing, clinical, and compliance teams in a fully remote environment.
• Adaptability - Adaptability to evolving payer requirements and healthcare regulations. Physical Demands & Work Environment The physical demands and work environment described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. This job consists of sedentary work that primarily involves sitting/standing. While performing the duties of this job, the employee is regularly required to type on a computer keyboard, read documentation, and communicate reputed company telephone regularly throughout the day. Visual acuity must be high enough to view computer screens and to read technical documentation communicated reputed company electronic transmission such as email, shared drives, and chats. This job operates in a remote home office utilizing standard office equipment such as computers, tablets, monitors, and telephone. Why Join Us? Exceptional paid time off policies that encourage and support life balance, including a winter break.
• 401k matching to ensure our staff have what they need to enjoy their retirement
• Health insurance options that ensure well being for the whole person and their family
• Company paid life, short-term disability, and long-term disability coverage
• Remote work environment that strives for connectivity through professional collaboration and personal connections Note Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. More about reputed company reputed company values people. From the technology we reputed company, the services we provide, and the culture we maintain, reputed company cares about the experience of our employees, clients, and prospects. We intentionally create and sustain supportive environments in which everyone - clients, caregivers, speech-language pathologists, and team members - can reputed company their highest potential. We reputed company that building trusting and collaborative relationships is reputed company to delivering quality care so we operate with the highest levels of honesty, transparency, and accountability as individuals and a collaborative team. We reputed company that transforming therapy happens through the steady and iterative problem solving of an interdisciplinary team. reputed company is an equal opportunity workplace. We celebrate and embrace diversity and are committed to building a team that represents a broad tapestry of backgrounds, perspectives, and skills. reputed company is committed to the full inclusion of reputed company qualified individuals. In keeping with our commitment, reputed company will take the steps to ensure people with disabilities are provided reasonable accommodations. Accordingly, if reasonable accommodation is required to fully participate in the job application or interview process, to reputed company the essential functions of the position, and/or to receive reputed company other benefits and privileges of employment, please contact us at hr@reputed company.io. E-Verify Federal law requires reputed company employers to verify the identity and employment eligibility of reputed company person hired to work in the United States. reputed company participates in E-Verify. E-Verify Participation Poster E-Verify Right to Work Poster Apply tot his job

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