Regulatory & Payer Operations Lead

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

Benefits offered by this job

Health insurance

401(k) match

Paid time off

Paid parental leave

Tuition reimbursement

Flexible hours

Job summary

Comfort Medical, LLC seeks a Regulatory & Payer Operations Support Specialist to lead office-level regulatory and payer operations. You will oversee Medicaid coordination, insurance verification, prior authorizations, and audit responses, ensuring compliance and exceptional service to patients and providers.

This role partners with clinical, operational, revenue cycle, and regulatory teams to maintain survey readiness and regulatory documentation, while supporting office administration and

Qualifications

• Minimum 2 years experience with Medicaid, Medicare, payer operations, revenue cycle, healthcare reimbursement, or regulatory compliance.
• Experience with insurance verification, prior authorization processing, or payer communications.
• Experience supporting audits, surveys, compliance reviews, or regulatory inspections.
• Strong documentation management and Microsoft Office skills.
• Excellent communication, organization, and problem-solving abilities.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Local point of contact for CMS, Medicaid, accreditation, and payer surveys.
• Maintain survey readiness and regulatory compliance with licensing, accreditation, and company requirements.
• Coordinate mock surveys, compliance audits, and readiness assessments; communicate findings and actions.
• Interpret Medicaid regulations, payer policies, and reimbursement requirements for the territory.
• Coordinate insurance eligibility verification and prior authorization support for patients.
• Assist with audits, medical record retrieval, and regulatory reviews; maintain trackers and deadlines.
• Support onboarding, training coordination, and personnel documentation management.

Skills

Medicaid experience

Payer operations

Insurance verification

Prior authorizations

Audits & compliance

MS Office

Organization & communication

Education

Associate or Bachelor's degree in healthcare/administration

Tools

Microsoft Office

Job description

Comfort Medical, LLC seeks a Regulatory & Payer Operations Support Specialist to lead office-level regulatory and payer operations. You will oversee Medicaid coordination, insurance verification, prior authorizations, and audit responses, ensuring compliance and exceptional service to patients and providers.

This role partners with clinical, operational, revenue cycle, and regulatory teams to maintain survey readiness and regulatory documentation, while supporting office administration and