Regulatory & Payer Operations Lead

Comfort Medical, LLC; Brevard (NC); Presencial; USD 27.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401(k) plan with company match

Generous paid time off

Flexible work hours

Tuition reimbursement

Descripción de la vacante

Comfort Medical, LLC is seeking a Regulatory & Payer Operations Support Specialist in Brevard, NC. The role coordinates Medicaid and payer activities, ensures survey readiness, and provides office-level regulatory and operational support including insurance verification and prior authorizations.

You will collaborate with clinical, revenue cycle, and regulatory teams to maintain compliance, efficiency, and exceptional patient service. Strong communication and Microsoft Office skills are essential.

Formación

• Minimum 2 years' experience with Medicaid, Medicare, payer operations, or regulatory compliance.
• Experience with insurance verification and prior authorization processing.
• Experience supporting audits, surveys, compliance reviews, or regulatory inspections.
• Strong Microsoft Office skills and documentation management.

Responsabilidades

• Serve as the local point of contact for CMS, Medicaid, accreditation, and payer surveys.
• Maintain survey readiness and regulatory compliance with licensing and accreditation.
• Coordinate mock surveys, compliance audits, and readiness assessments; communicate findings.
• Support Medicaid coordination and payer communications across teams.
• Provide updates on payer requirements and regulatory changes.
• Conduct insurance eligibility verification and prior authorization support.
• Coordinate collection of documentation for audits and regulatory reviews.
• Maintain audit trackers and monitor response deadlines.
• Support onboarding, training coordination, and personnel documentation.

Conocimientos

Medicaid operations

Insurance verification

Prior authorization

Regulatory compliance

Microsoft Office

Communication skills

Educación

Healthcare administration degree

Descripción del empleo

Comfort Medical, LLC is seeking a Regulatory & Payer Operations Support Specialist in Brevard, NC. The role coordinates Medicaid and payer activities, ensures survey readiness, and provides office-level regulatory and operational support including insurance verification and prior authorizations.

You will collaborate with clinical, revenue cycle, and regulatory teams to maintain compliance, efficiency, and exceptional patient service. Strong communication and Microsoft Office skills are essential.