Payer Audit Analyst — Revenue Cycle & Appeals

BrightSpring Health Services Corporation; Vancouver (WA); On-site; USD 28,000 - 29,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Company-Paid Short & Long-Term Disab.

Flexible schedules & Paid Time Off

Tuition Reimbursement

Employee Discount Program & DailyPay

401k

Pet Insurance

Job summary

PharMerica is seeking a Payer Audit Specialist to receive and process commercial and government payer audit requests for select locations. You will review documentation, perform quality assurance, and coordinate with RCM Ancillary Services toward final resolution.

The role emphasizes strong customer service, analytical problem solving, and multi-tasking; schedule is Monday–Friday 8 am–4:30 pm PST, with competitive pay and comprehensive benefits including health, dental, vision, life insurance

Qualifications

• Two to four years of revenue cycle management experience.
• Knowledge of Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement.
• Experience with CPR+ and Waystar is a plus.
• Familiarity with ICD-9/10, CPT, HCPCS coding and medical terminology.
• Proficiency in Microsoft Office and typing 40+ WPM.
• Strong verbal and written communication; ability to interpret information and compose audit responses.
• Flexibility to work evenings, weekends and holidays as needed.
• Knowledge of federal and state regulations related to revenue cycle management.

Responsibilities

• Ensures daily cash collections, payer audits, credit balances, medical records, correspondence, appeals/disputes, AR over 90 days and other goals.
• Receives, documents, processes and tracks all incoming payer audit requests and updates until final resolution.
• Coordinates across departments to ensure audits receive proper review, appeals and resolution.
• Assembles documentation, composes appeal responses, and submits to payers in required format.
• Responds timely to all payer audit requests and deadlines.
• Analyzes payer audit trends and communicates improvement needs to the RCM Ancillary Services management team.
• Works within established departmental goals and performance metrics.

Skills

Verbal and written communication

Customer service

Analytical thinking

Multitasking

Attention to detail

Education

High school diploma / GED

Some college

Tools

CPR+

Waystar

Job description

PharMerica is seeking a Payer Audit Specialist to receive and process commercial and government payer audit requests for select locations. You will review documentation, perform quality assurance, and coordinate with RCM Ancillary Services toward final resolution.

The role emphasizes strong customer service, analytical problem solving, and multi-tasking; schedule is Monday–Friday 8 am–4:30 pm PST, with competitive pay and comprehensive benefits including health, dental, vision, life insurance