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Payment Integrity Specialist

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Personify Health

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Location:
United States

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Category:
Health and Beauty

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Contract Type:
Employment contract

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Salary:

23.00 - 26.00 USD / Hour
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Job Description:

The role is responsible for managing complex healthcare claim negotiations and ensuring compliance with federal regulations.

Job Responsibility:

  • Complete No Surprise Act Negotiations and defend employer groups in the NSA and IDR appeal process
  • Review Itemized Bills and prepare them for physician review including OCR and Spreadsheet entry and formatting
  • Prepares and negotiate settlements with providers
  • Follows up with providers on unsigned settlements
  • Releases claims in the various TPA systems
  • Assist with SCA negotiations

Requirements:

  • At least 5 years of experience in a TPA, Payment Integrity, Revenue Cycle management, and/or coding
  • High school diploma
  • Knowledge of medical terminology and medical billing terminology
  • Experience with Excel, OCR, and strong software and technical proficiency
  • Attention to detail and organizational efficiency
  • Ability to manage multiple stakeholders and deadlines
  • Strong negotiation and dispute resolution skills
  • Self-starter and self-motivated
What we offer:
  • Competitive base salary and benefits effective day one
  • Comprehensive medical and dental through our own health solutions
  • Paid Time Off
  • Mental health support, retirement planning, and financial protection
  • Professional development with clear career progression and learning budgets
  • Mission-driven culture

Additional Information:

Job Posted:
May 05, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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