Regulatory & Payer Operations Lead — Flexible Hours

Coloplast; Texarkana (TX); On-site; USD 27,000 - 39,000; Full time

Job summary

Coloplast in Texarkana, TX is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory, payer, and operational support. The role supports Medicaid coordination, survey readiness, insurance verification, prior authorization, audits, and records management, working with clinical, revenue cycle, and regulatory teams to ensure compliance and exceptional patient service.

The position requires at least 2 years of Medicaid/Medicare payer experience, strong Microsoft Office

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 Microsoft Office skills and documentation management capabilities.
• Excellent communication, organization, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Responsibilities

• Regulatory Affairs: local point of contact for CMS, Medicaid, accreditation, and payer surveys; maintain compliance and readiness.
• Medicaid & Payer Relations: liaise with Medicaid agencies, managed care organizations, and payer teams; resolve eligibility and authorization issues.
• Insurance Verification & Prior Authorization Support: verify eligibility, submit and track prior authorization requests; communicate status to patients and providers.
• Audit Response & Medical Records Support: collect supporting documentation, chase records, and ensure accuracy and timely submission.
• Office Administrative Support: support onboarding, training coordination, and record management; promote compliance and ethics.

Skills

Medicaid experience

Payer coordination

Microsoft Office

Documentation management

Communication skills

Organisation and problem-solving

Education

Healthcare administration / related field degree

Tools

Microsoft Office

Job description

Coloplast in Texarkana, TX is seeking a Regulatory & Payer Operations Support Specialist to lead local regulatory, payer, and operational support. The role supports Medicaid coordination, survey readiness, insurance verification, prior authorization, audits, and records management, working with clinical, revenue cycle, and regulatory teams to ensure compliance and exceptional patient service.

The position requires at least 2 years of Medicaid/Medicare payer experience, strong Microsoft Office