Senior Workers' Compensation Compliance Analyst

Reliant Health Partners LLC

Remote, US
Base: $65,000 - $70,000 usd; bonus/equity: eligibl...
Remote
5+ years healthcare fraud or compliance experience
3+ years medical reimbursement methodologies
Knowledge of state fee schedule rules and statutes
The role involves reviewing state fee schedule rules and regulations to identify compliance risks and assist in implementing system changes for risk mitigation

Job Summary

  • The role involves reviewing state fee schedule rules and regulations to identify compliance risks and assist in implementing system changes for risk mitigation.
  • Candidates will be responsible for handling high-level appeals, negotiating with attorneys for state disputes, and establishing special reimbursement policies.
  • The company offers comprehensive benefits including medical, dental, vision, life insurance, a 401(k) match, and paid time off.

Matching Summary

The role involves reviewing state fee schedule rules and regulations to identify compliance risks and assist in implementing system changes for risk mitigation.

Salary

Base: $65,000 - $70,000 USD; Bonus/Equity: Eligible for additional compensation including bonuses and merit increases; Benefits: Comprehensive medical, dental, vision, life insurance, 401(k) match, HSA, FSA, PTO

Skills & Requirements

Must-have

  • 5+ years healthcare fraud or compliance experience
  • 3+ years medical reimbursement methodologies
  • Knowledge of state fee schedule rules and statutes
  • Experience drafting reconsideration letters and disputes
  • Ability to negotiate with attorneys for state disputes

Nice-to-have

  • Strong analytical and critical thinking skills
  • Self-starter with ability to work independently
  • Creative thinking for risk mitigation strategies
  • Excellent oral and written communication abilities
  • Intermediate or advanced Excel and PowerPoint skills

Key Requirements

  • 5+ years in healthcare fraud, compliance, or legal experience
  • 3+ years working with medical reimbursement methodologies
  • 3+ years understanding medical coding and billing patterns
  • Knowledge of limited liability in property and casualty insurance

Work Rights

Not specified

Tailored Resume

Cover Letter