Senior Payer Denials & Claims Specialist

Piedmont Healthcare Inc.; Oregon; Ibrido; USD 65.000 - 90.000; Tempo pieno

Descrizione del lavoro

Piedmont Healthcare Corporate is seeking an experienced senior specialist to resolve the most complex claim issues, denials and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit-ready documentation.

The Senior Specialist will act as a subject matter expert, support training and quality initiatives, and collaborate with leadership to improve processes and payer performance.

Competenze

• H.S. Diploma or GED required.
• 3 years of hospital billing/denial management experience.
• Experience with complex payer types; Medicare Advantage, Medicaid Managed Care, Workers' Compensation, TPL, MSP preferred.

Mansioni

• Resolve the most complex claim issues, denials, and payer escalations.
• Act as subject matter expert; support training and quality initiatives.
• Partner with leadership to improve processes and payer performance.

Conoscenze

Hospital billing

Denial management

Payer rules

Formazione

GED

Strumenti

Epic

Descrizione del lavoro

Piedmont Healthcare Corporate is seeking an experienced senior specialist to resolve the most complex claim issues, denials and payer escalations. This role requires advanced knowledge of payer rules, regulatory requirements, and audit-ready documentation.

The Senior Specialist will act as a subject matter expert, support training and quality initiatives, and collaborate with leadership to improve processes and payer performance.