Analyzes allowed amounts received on USAP claims for appropriateness per contract
Reviews electronic and manual postings associated with variances
Appeals for re-processing and requests corrections as necessary
Identifies and resolves payer issues that negatively impact receivables
Frequently communicates with various departments and insurance companies
Requires independent thinking, problem solving, and strong analytical skills

High school graduate or equivalent required
Minimum of 2 years experience in healthcare revenue cycle
Functional knowledge of Excel and Word required
Basic knowledge of managed care programs and healthcare billing requirements necessary
Good mathematical, verbal, and written communication skills
Must display a teamwork attitude and possess good interpersonal skills
Familiarity with basic medical terminology and concepts preferred
Knowledge of CPT, ICD-9, and ASA coding preferred

Payer Compliance Specialist I

Key skills