Payer Audit Specialist: Revenue Cycle & Compliance

Pharmerica; Vancouver (WA); On-site; USD 28,000 - 29,000; Full time

Benefits offered by this job

Competitive Pay

Health, Dental, Vision & Life

Company-Paid Disability

Flexible Schedules & PTO

Tuition Reimbursement

Employee Discount & DailyPay

401k

Pet Insurance

Job summary

PharMerica is seeking a Payer Audit Specialist to handle commercial and government payer audit requests for select locations. You will review requests, compile documentation, identify required medical records, and perform quality checks before submission.

In this role you will coordinate across departments to ensure proper reviews, appeals, and timely responses, while adhering to regulations and company policies. A strong customer service focus is essential.

Qualifications

• Minimum two to four years in revenue cycle management.
• Experience with Managed Care, Commercial, Government, Medicare, and Medicaid reimbursement.
• Experience with CPR+ and Waystar preferred.
• Knowledge of ICD-9/10, CPT, HCPCS coding and medical terminology.
• Strong MS Office skills and typing 40+ WPM.

Responsibilities

• Ensures daily accomplishments toward cash collections, payer audits, credit balances, medical records, and correspondence.
• Adheres to state/federal regulations and company policies.
• Receives, documents, processes, and tracks all incoming payer audit requests to resolution.
• Coordinates with departments to ensure proper review, appeals, and resolution of audits.
• Assembles documentation and submits appeal responses in required payer format.
• Responds timely to all payer audit requests and deadlines.
• Analyzes payer audit trends and communicates improvement needs.

Skills

Verbal communication

Written communication

Attention to detail

MS Office

Typing speed

Education

High School diploma/GED

Tools

CPR+

Waystar

Billing systems

Job description

PharMerica is seeking a Payer Audit Specialist to handle commercial and government payer audit requests for select locations. You will review requests, compile documentation, identify required medical records, and perform quality checks before submission.

In this role you will coordinate across departments to ensure proper reviews, appeals, and timely responses, while adhering to regulations and company policies. A strong customer service focus is essential.