Payer Specialist

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

📋 Description

• Ensure prompt billing for all payers within the designated region, including secondary billing.

• Maintain precise notes and communication within the patient’s ledger/chart.

• Verify insurance information for accuracy, collaborating with the PC when discrepancies arise.

• Work with all relevant parties to uphold denial prevention strategies.

• Follow up on Accounts Receivable by insurance, gathering necessary information to ensure claims are processed or appealed.

• Engage directly with payers through phone, email, or other required communication methods.

• Oversee third-party vendors to ensure successful claims payment.

• Research, establish, prepare, and test new payer information, including contract details, reimbursement terms, claim form requirements, billing and collections stipulations, and timely filing prerequisites.

• Monitor and address discrepancies related to partial payments and contracts.

• Assist PCs and patients with inquiries related to billing.

• Collaborate individually with users across all company sectors to resolve issues.

• Generate reports as necessary.

• Perform additional duties as assigned.

⛳️ Requirements

• A high school diploma or GED equivalent is required.

• At least three years of experience in various aspects of the healthcare payer environment.

• Proficient in using Microsoft Outlook, Word, Excel, and Access.

• Excellent verbal communication skills and phone demeanor.

• Strong understanding of quality customer service principles.

• Proven ability to prioritize tasks and work with urgency.

• Familiarity with diverse EMR systems.

• Experience with Raintree is an advantage.

🏝️ Benefits

• Eligibility for a comprehensive benefits package starting within your first month of employment.

• Generous Paid Time Off (PTO) plans.

• Paid holidays.