MedVanta is the nation's largest physician-owned and operated next generation management services organization (MSO), specializing in musculoskeletal (MSK) providers. The RCM Payer Reimbursement Integrity Specialist ensures payer reimbursements comply with contract terms, federal and state regulations, and healthcare policies by performing analysis, audits, and data management to identify discrepancies and optimize revenue.
Responsibilities include reviewing fee schedules, payer contracts, conducting reimbursement audits, analyzing complex reimbursement methodologies, collaborating with billing and coding departments, developing reimbursement strategies, preparing management reports, educating staff on reimbursement compliance, and maintaining HIPAA and regulatory compliance. The role requires strong analytical skills, communication abilities, and the capacity to work independently.
Physical demands include prolonged sitting, ability to lift up to 25 pounds, repetitive hand movements, and clear communication capability.
- High school diploma required; Bachelor's degree preferred.
- Minimum 3 years' experience in a medical billing office.
- Advanced Microsoft Office, EMRs, and payer website proficiency.
- Minimum 3 years' experience with payer contracts, auditing payments, and contract management software.
- Proven understanding of healthcare reimbursement methodologies, payer contracts, and relevant regulations.
- Strong analytical, organizational, and communication skills.
- Ability to work independently and collaboratively in a dynamic environment.
Location
Maryland, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago