Regulatory & Payer Compliance Ops Lead

Comfort Medical, LLC; Minneapolis (MN); On-site; USD 27,000 - 39,000; Full time

Job summary

Comfort Medical, LLC is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory and payer coordination and provide office support. You will manage Medicaid coordination, insurance verification, prior authorizations, and audit response coordination.

Collaborate with clinical, revenue cycle, and regulatory teams to ensure compliance, operational efficiency, and exceptional service to patients and customers in a fast-paced healthcare environment.

Qualifications

• Minimum 2 years' experience with Medicaid, Medicare, payer operations, 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 and documentation management skills.
• Excellent communication, organization, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Serve as the local regulatory and payer liaison for CMS, Medicaid, and surveys.
• Maintain survey readiness and regulatory compliance.
• Coordinate audits and readiness assessments; communicate findings and corrective actions.
• Support Medicaid and payer relations within the territory; update on regulations.
• Verify insurance eligibility and process prior authorizations; inform stakeholders.
• Coordinate collection of documentation for audits and reviews.
• Support office administration and onboarding; maintain records and logs.

Skills

Medicaid knowledge

Payer operations

Regulatory compliance

Communication skills

Organization

Problem solving

Microsoft Office

Documentation management

Multitasking

Education

Healthcare administration / related field degree

Tools

CMS systems

Job description

Comfort Medical, LLC is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory and payer coordination and provide office support. You will manage Medicaid coordination, insurance verification, prior authorizations, and audit response coordination.

Collaborate with clinical, revenue cycle, and regulatory teams to ensure compliance, operational efficiency, and exceptional service to patients and customers in a fast-paced healthcare environment.