Regulatory & Payer Operations Lead (Medicaid & Audits)

Coloplast; Brevard (NC); On-site; USD 27,000 - 39,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

401(k) plan

Paid time off

Tuition reimbursement

Job summary

Coloplast in Brevard, NC seeks a Regulatory & Payer Operations Support Specialist to lead local regulatory, payer, and office operations. You will support Medicaid coordination, insurance verification, prior authorizations, audits, and records retrieval.

The role collaborates with clinical, revenue cycle, regulatory teams to ensure compliance and exceptional service to patients and customers. Minimum 2 years in Medicaid/ payer operations preferred.

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.

Responsibilities

• Serve as the local point of contact for CMS, Medicaid, accreditation, and payer surveys.
• Maintain continuous survey readiness and regulatory compliance.
• Coordinate mock surveys and audits with findings and corrective actions.
• Coordinate collection of supporting documentation for audits and regulatory reviews.
• Support onboarding, training coordination, and personnel documentation management.

Skills

Microsoft Office

Documentation management

Communication

Organization

Problem solving

Education

Associate or Bachelor's degree in Healthcare Administration

Job description

Coloplast in Brevard, NC seeks a Regulatory & Payer Operations Support Specialist to lead local regulatory, payer, and office operations. You will support Medicaid coordination, insurance verification, prior authorizations, audits, and records retrieval.

The role collaborates with clinical, revenue cycle, regulatory teams to ensure compliance and exceptional service to patients and customers. Minimum 2 years in Medicaid/ payer operations preferred.