Payer Appeals & QA Specialist

Bioventus LLC; Memphis (TN); On-site; USD 65,000 - 90,000; Full time

Job summary

Bioventus LLC is seeking a Quality Assurance Insurance Specialist to support reimbursement strategies by handling payer audits and appeals processing. You will review documentation, ensure quality assurance, and communicate with management to address issues and trends.

The role includes coordinating all appeals processes and collaborating with billing and compliance teams. Ideal candidates have 5–7 years in insurance compliance or medical claims, strong knowledge of Medicare, and excellent

Qualifications

• Requires 5–7 years in insurance compliance, QA, or medical claims in regulated environments.
• Knowledge of Medicare and government program regulations is required.
• Strong communication and documentation skills are essential.

Responsibilities

• Serve as liaison for payer audits and appeals processing.
• Review medical records and policy guidelines to support denials and denials appeals.
• Coordinate with billing and compliance teams to improve QA methods and reporting.

Skills

Insurance compliance

Quality assurance

Medical claims

Reading medical records

Medicare knowledge

Communication

Organizational skills

Education

High School diploma or GED

Associates degree preferred

Tools

Microsoft Office Suite

Document control systems

Quality management systems

Job description

Bioventus LLC is seeking a Quality Assurance Insurance Specialist to support reimbursement strategies by handling payer audits and appeals processing. You will review documentation, ensure quality assurance, and communicate with management to address issues and trends.

The role includes coordinating all appeals processes and collaborating with billing and compliance teams. Ideal candidates have 5–7 years in insurance compliance or medical claims, strong knowledge of Medicare, and excellent