Payer Profile Specialist

National Seating & Mobility • North Region-Remote,

8d • Hybrid

About The Position

The Payer Profile Specialist is primarily responsible for maintaining the accuracy of the company’s Universal Payer Database, which tracks essential payer-specific information to support funding, billing, and collection departments. This role manages payer web portal access, supports management projects, and serves as a central point of contact for cross-functional teams to resolve database and access requests with speed and precision.

Requirements

• High School Diploma or equivalent required.
• 1–2 years of medical office experience required.
• Solid understanding of medical terminology, including modifiers, allowables, Remittance Advice (RA), and Coordination of Benefits (COB).
• Written and verbal communication skills required for professional correspondence with payers and internal teams.

Nice To Haves

• A 2-year degree in Business or Healthcare Administration is preferred.
• Direct experience with Durable Medical Equipment (DME), documentation requirements, insurance policy guidelines, and medical billing is highly preferred.
• Professional certifications in Microsoft Office or Adobe Acrobat are preferred.

Responsibilities

• Lead the research, setup, and testing of new payer data, including reimbursement terms, claim requirements, and filing deadlines, within the Universal Payer Database.
• Partner with internal users across the organization to troubleshoot and resolve payer data issues efficiently.
• Communicate directly with insurance payers via phone and email to verify, clarify, and update contract information.
• Audit and maintain the accuracy of information on the company intranet and securely manage user access for various payer web portals.
• Maintain a professional workspace and adhere to regular, predictable attendance standards to support high-volume operations.

What This Job Offers

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