Payment Accuracy Specialist

Jobgether

2d • $29 - $33 • Remote

About The Position

This role is focused on ensuring the accuracy and integrity of healthcare payments through detailed audits, data analysis, and process improvement. You will investigate complex claims, develop and validate audit concepts, and identify recoverable opportunities to maximize financial accuracy for clients. The position offers a mix of independent analytical work, collaboration with cross-functional teams, and mentorship of less-tenured specialists. You will work with proprietary systems, large datasets, and client-specific rules to detect billing discrepancies, support process improvements, and provide actionable insights. This is a fast-paced environment that values attention to detail, critical thinking, and proactive problem-solving, with opportunities for professional growth and technical skill development.

Requirements

• High school diploma required; bachelor’s degree preferred or equivalent healthcare experience (4–6 years)
• Minimum 3–4 years of experience in healthcare auditing, claims analysis, or payment integrity
• Strong knowledge of claim adjustments, provider contracts, reimbursement policies, and compliance regulations
• Advanced proficiency in Microsoft Excel and other client applications; SQL experience strongly preferred
• Demonstrated ability to analyze large datasets and generate actionable insights
• Excellent verbal and written communication skills, with ability to explain complex findings clearly
• Ability to work independently and collaboratively within a team environment
• Strong attention to detail, critical thinking skills, and professional skepticism
• Experience with auditing tools and systems (e.g., Recovery Management System) preferred

Responsibilities

• Audit client data and identify potential overpayments or compliance issues across healthcare claims
• Develop, validate, and refine new and existing audit concepts for client approval
• Train and mentor other specialists on audit processes, tools, and standards
• Conduct complex audits independently, applying advanced analysis and professional judgment
• Collaborate with engineering and data teams to enhance tools, reports, and reporting efficiency
• Ensure adherence to client contracts, regulatory guidelines, and internal policies, including HIPAA compliance
• Document audit findings, generate high-quality recoverable claims, and provide clear justifications for results

Benefits

• Competitive hourly compensation ($29–$33/hr) with eligibility for discretionary bonuses
• Overtime pay for eligible nonexempt employees
• Comprehensive benefits package including medical, dental, vision, life, and disability insurance
• 401(k) retirement savings plan
• Paid family leave and flexible Paid Time Off (17–27 days depending on tenure)
• 9 paid holidays per year
• Remote work flexibility with required secure home office setup and high-speed internet

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED