As a CSI CareTend Payer Specialist, you will maintain and update payer configurations in CareTend including billing and per diem rules, manage payer profiles, oversee payer contract pricing sheets, and ensure revenue integrity through auditing. You will enroll payers in EDI systems like Waystar, assist with EFT enrollments, create and maintain payer instruction documentation, and facilitate communication regarding contract pricing. Compliance with HIPAA and company core values is essential.

This role requires strong professionalism, time management, customer service experience, analytical problem-solving skills, medical terminology knowledge, and proficiency in Microsoft Office and billing platforms (CareTend or CPR+, Waystar).

Education requires a High School Diploma or GED, with an associate or bachelor's degree in healthcare or related field preferred. Candidates should have 5-7 years experience in home infusion, specialty pharmacy, or healthcare settings, and experience with major payers such as Medicare, Medicaid, PBM, and commercial insurance.

Ability to perform each essential duty satisfactorily
Professionalism, responsiveness, communication skills
Effective time management and multitasking
Experience in customer service and satisfaction evaluation
Strong analytical and problem-solving abilities
Excellent verbal and written communication
Self-motivated, able to work independently
Working knowledge of basic medical terminology
Proficiency in Microsoft Office (Excel, Outlook, Word)
High School Diploma or GED required
Associate or bachelor's degree preferred (healthcare concentration or related field)
5 to 7 years experience in home infusion, specialty pharmacy, or healthcare setting
Experience with Medicare, Medicaid, PBM, commercial insurance
Proficiency in CareTend or CPR+ and Waystar billing platforms