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 abilities to resolve underpayments and communicate effectively with internal teams and external payers.

Highest-signal resume keywords

Healthcare Revenue Cycle ManagementPayer Compliance ManagementVariance AnalysisAppeals ProcessingCPT, ICD-9, and ASA Coding

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer Compliance ManagementVariance AnalysisAppeals ProcessingHealthcare Billing RequirementsCPT CodingICD-9 CodingASA CodingExcelWordAnalytical Abilities

Soft Skills

Good Communication SkillsTeamwork AttitudeInterpersonal SkillsAbility to Work Independently

Industry Keywords

Managed Care ProgramsHealthcare Revenue CycleMedical TerminologyPayer PoliciesContractual Terms

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 with payers
Follow up on appeal results 45–60 days after submission
Partner with leadership to research and report payer systemic 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 about payer variance issues
Communicate with internal RCM departments and insurance companies
Identify and resolve payer issues negatively impacting receivables

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 be able to meet the physical requirements of the job, with or without reasonable accommodation
Must be able to communicate verbally and in writing
Candidates residing in California, Hawaii, or Alaska are not hired

Benefits

Comp & perks

Quarterly bonus eligibility
Equal employment opportunities
Reasonable accommodations for individuals with disabilities