Payer Audit & Compliance Specialist

Seneca Resources Company, LLC; Birmingham (AL); On-site; USD 52,000 - 72,000; Full time

Job summary

Seneca Resources is seeking a Compliance Specialist - Audit Support in Birmingham, AL to manage and support external commercial payer audits and help ensure regulatory and payer compliance across Revenue Cycle, Compliance, HIM, Billing, and Operations.

The ideal candidate is organized, analytical, and skilled at navigating complex healthcare audit processes, with a proven ability to coordinate across teams, document evidence, and drive timely outcomes.

Qualifications

• Bachelor’s degree or equivalent in a related field and 2+ years in healthcare compliance, audits, or revenue cycle.
• Strong analytical, problem-solving, and organizational skills.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and deadlines in a fast-paced environment.

Responsibilities

• External Audit Management: manage full audit lifecycle including intake, review, documentation, submission, appeals, and closure.
• Appeals & Resolution: prepare and submit audit appeals with supporting documentation and monitor determinations.
• Compliance & Process Improvement: align activities with policies, maintain audit inventories, identify risks and opportunities, and contribute to policies and workflow improvements.
• Collaboration: work with Revenue Cycle, Compliance, Coding, Billing, Clinical Operations and other stakeholders to validate documentation and communicate findings.

Skills

Analytical skills

Organizational skills

Written and verbal communication

Education

Bachelor’s degree in Healthcare Administration, Business, Finance, Compliance, or related field

Tools

Excel

Audit tracking systems

Job description

Seneca Resources is seeking a Compliance Specialist - Audit Support in Birmingham, AL to manage and support external commercial payer audits and help ensure regulatory and payer compliance across Revenue Cycle, Compliance, HIM, Billing, and Operations.

The ideal candidate is organized, analytical, and skilled at navigating complex healthcare audit processes, with a proven ability to coordinate across teams, document evidence, and drive timely outcomes.