Payer Compliance Specialist I

US Anesthesia Partners

. Follow payer compliance management standard operating procedures .

Posted 9/23/2026full-timeRemote • United StatesJuniorMid-Level💰 $16 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare revenue cycle management, including payer compliance, appeals processing, and variance analysis. Proficient in Excel and Word, with strong analytical and communication skills to effectively address payer issues and collaborate with leadership.

Highest-signal resume keywords

Healthcare Revenue Cycle ManagementPayer Compliance ManagementVariance AnalysisExcel ProficiencyCPT, ICD-9, and ASA Coding Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer Compliance ManagementVariance AnalysisAppeals ProcessingHealthcare Billing RequirementsExcel ProficiencyWord ProficiencyAnalytical AbilitiesCPT CodingICD-9 CodingASA Coding

Soft Skills

Good Communication SkillsTeamwork AttitudeInterpersonal SkillsAbility to Work IndependentlyProblem-Solving Skills

Industry Keywords

Managed Care ProgramsHealthcare Revenue CyclePayer PoliciesContractual TermsMedical Terminology

About the role

Key responsibilities & impact

Follow payer compliance management standard operating procedures
Analyze, evaluate, and validate payer under- and over-allowable variances in work queues
Manage corrective actions through appeals, cross-workflow, or escalation to management
Gather appeal documentation and file appeals to payers
Follow up on appeal results 45–60 days after submission
Partner with leadership to research and report systemic payer issues creating variance trends
Use the out-of-model guidance matrix to report over-allowed variances to leadership and finance
Learn payer policies and contractual terms
Research and respond to refund requests and take appropriate action
Inquire with leadership and contract management about potential contract term discrepancies
Communicate regularly with management regarding payer variance issues
Perform occasional standing and walking, frequent sitting and hand/finger movement, and use office equipment while communicating verbally and in writing

Requirements

What you’ll need

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
Analytical abilities to identify and resolve underpayments relating to specific payers and coding issues
Good mathematical, verbal, and written communication skills
Experience gathering and reporting information
Teamwork attitude and good interpersonal skills
Ability to work independently with limited supervision
Familiarity with basic medical terminology and concepts preferred
Knowledge of CPT, ICD-9, and ASA coding preferred
Must reside in the United States, excluding California, Hawaii, and Alaska

Benefits

Comp & perks

Quarterly bonus eligibility (not guaranteed; based on company and individual performance)
Reasonable accommodations for individuals with disabilities
Equal employment opportunities