Payer Integration Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Facilitate communication with payers to establish both technical and operational connectivity.

• Convert payer-specific requirements into actionable steps for internal team implementation.

• Oversee daily payer connectivity for standard integration systems.

• Act as the main point of contact for health plan integration setups, concentrating on eligibility, claims, and billing workflows.

• Engage in customer and partner kickoff meetings, serving as a bridge between internal teams and external stakeholders.

• Implement, configure, and troubleshoot technical integrations for health plans and health systems.

• Collaborate with Sales, Product, Engineering, Payer Billing Operations, and Customer Success throughout the customer journey.

• Manage project plans, timelines, and milestones to ensure timely and accurate delivery.

• Assist with annual benefit updates to uphold data integrity.

• Participate in additional directed projects.

• Convert health plan requirements into automated workflows, manage custom network exceptions, and minimize billing friction.

• Configure RCM system rules for smooth carrier connectivity.

⛳️ Requirements

• A minimum of 3 years of experience in a high-growth, fast-paced environment.

• Profound understanding of health plan structures, payer operations, claims billing, and utilization management workflows.

• Practical experience with RTE (270/271), claims (837), accumulators, and/or similar healthcare integrations, ideally including systems like Asana and Salesforce.

• Strong project management capabilities with the ability to handle multiple work streams and competing priorities.

• Outstanding communication skills and the ability to collaborate effectively with both technical and non-technical stakeholders.

• Comfortable navigating ambiguity, anticipating risks, and proactively resolving issues.

• Enthusiasm for collaborating across internal teams, both leading and supporting various stakeholders.

🏝️ Benefits

• Comprehensive healthcare coverage, including medical, dental, vision, FSA/HSA, life, and disability insurances.

• Lyra for Lyrians; access to coaching and therapy services.

• Opportunity for equity in the company through discretionary restricted stock units.

• Competitive paid time off policies, including vacation, sick days, and company holidays.

• Paid parental leave.

• 401K plan with up to 3% matching.

• Monthly technology allowance.

• Well-being perks and activities.

• Surprise swag.

• Regular community celebrations.