Medicaid & Payer Compliance Specialist

Coloplast; Ventura (CA); On-site; USD 27,000 - 39,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) with company match

Paid time off

Parental leave

Job summary

Coloplast in Ventura, CA is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory and payer activities. You will coordinate Medicaid and payer surveys, verify insurance eligibility, and manage prior authorizations while supporting audits and records retrieval.

You will collaborate with regulatory, revenue cycle, clinical, and operations teams to ensure compliance and efficient service to patients and customers.

Qualifications

• Minimum 2 years' experience with Medicaid, Medicare, payer operations, revenue cycle, healthcare reimbursement, or regulatory compliance.
• Experience with insurance verification, prior authorization processing, or payer communications.
• Experience supporting audits, surveys, compliance reviews, or regulatory inspections.
• Strong Microsoft Office skills and documentation management capabilities.
• Excellent communication, organization, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Serve as the local regulatory, payer, and operational support lead.
• Coordinate Medicaid and payer surveys, audits, and readiness.
• Provide insurance verification and prior authorization support; communicate statuses to patients and providers.
• Support audit responses, medical records retrieval, and documentation accuracy.
• Coordinate office administrative operations and onboarding-related tasks.

Skills

Medicaid experience

Payer operations

Communication skills

Problem solving

Education

Associate or bachelor’s degree in healthcare administration or related field

Tools

Microsoft Office

Job description

Coloplast in Ventura, CA is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory and payer activities. You will coordinate Medicaid and payer surveys, verify insurance eligibility, and manage prior authorizations while supporting audits and records retrieval.

You will collaborate with regulatory, revenue cycle, clinical, and operations teams to ensure compliance and efficient service to patients and customers.