Job Description

It is an exhilarating time of growth for USPh, and we are currently looking for a Payment Compliance Specialist to join our team. Reporting to the Director of Managed Care Reimbursement, you will work with cross-functional teams on projects for which you will ensure compliance with federal and state laws and regulations. Your coding and classification systems expertise will enable you to develop policies and procedures that promote quality and accuracy in our coding practices.

This role involves providing expert guidance on coding accuracy, billing edits, and denials to ensure compliance with regulatory requirements.

Responsibilities:

• Assist with the implementation of managed care fee schedule allowable project.
• Review payer policies for updates and changes that may impact reimbursement.
• Research claim denial issues and root cause problem-solving with payers.
• Support Payment Compliance and Chargemaster teams as needed.
• Demonstrate ability and commitment to excellent customer service to develop and maintain effective working internal & external relationships.
• Able to effectively manage conflicting priorities, adapt to ever-changing responsibilities, and meet highly structured deadlines
• Ability to manage multiple projects efficiently and accurately

Qualifications

• A Bachelor's degree in business, health care, or a related field is preferred, but a high school diploma and an appropriate combination of education and experience are required.
• 3+ years' experience in a healthcare setting
• Expertise in healthcare payer contracts, healthcare billing/payment processes
• Experience with Availity and Raintree, preferred
• Knowledge of physical, occupational, and speech therapy is preferred.
• Proficient in Microsoft Office software applications, including advanced Outlook skills, Excel, Pivot Tables, etc.
• Thorough understanding of managed care claim lifecycle.
• Ability to work autonomously and with cross-functional teams.

Additional Information

Benefits:

• Generous paid time off with holidays
• Continuous mentoring to further your career path
• Investment from a company that wants you to succeed and thrive
• Great close-knit team environment. We work hard, but we have fun!

This position's anticipated base salary range is $45,000 - $55,000. Salary is based on various factors, including relevant experience, knowledge, skills, other job-related qualifications, and geography. Medical, dental, vision, 401(k), paid time off, and other benefits are also available, subject to the terms of the Company's plan.